ALLAN GAIR, pictured here inside the Surgical Waiting Area at Health First’s Holmes Regional Medical Center, has been a hospital volunteer for 18 years. When an acute ischemic stroke began April 10, a hospital associate spotted what was happening, and Allan was treated right away. Today, he’s back to his duties and feeling good. His quick treatment resulted in no lasting complications.

May is American Stroke Month, and leaders at Health First are asking the public to B.E. F.A.S.T. spotting a stroke and take appropriate action. Longtime volunteer Allan Gair is all-in for the cause.

Gair has volunteered for Health First for 18 years, and it’s rewarded him in meaningful relationships and discoveries, but it’s never paid off like it did April 10.

At the lab to get a blood draw performed, an associate taking his registration noticed he was unable to find the words – like his name – to sign in at the desk. His facial muscles were starting to droop.

Gair was suffering an acute ischemic stroke with symptoms of aphasia. In a stroke, a part of the brain is unable to get oxygenated blood, commonly because of a clot (ischemic), occasionally because a blood vessel has burst (hemorrhagic). Without oxygen, the affected part of the brain begins to die. At some point, it cannot be revived. Each minute brings permanent damage closer.

Gair was fortunate. His stroke onset took place at a hospital. “That wheelchair was next to me in a snap, and I had nurses flocking to me.”

A Modern Stroke Center’s Advantages

Gair’s condition prompted a hospital Stroke Alert. A CT scan of his brain was ordered. A software platform called Viz.ai (the “ai” stands for artificial intelligence) reviews scans in seconds and highlights blockages (a radiologist also reviews all images, whether or not the software selects any). Gair was quickly given Tenecteplase, an intravenous bolus that dissolves the clot and restores blood flow to the brain, just 22 minutes after his symptoms were spotted.

The average time for such treatment is more than 2.5 hours.

Several years ago, an amazing breakthrough happened in stroke medicine. It’s called endovascular thrombectomy (EVT). In it, an interventional neurologist, guided by X-ray, threads a catheter up an artery and into the brain and physically retrieves the blood clot.

Holmes Regional is the area’s only Joint Commission Accredited Thrombectomy Center and has been performing the procedures under the direction of Interventional Neuroradiologist Fawad Shaheen, MD, for about a decade. The Stroke Team’s work has grabbed some headlines.

Within the last three years, Health First onboarded Viz.ai, which alerts the Stroke Team over smartphones, sending images physicians can study and evaluate for themselves.

In a stroke, minutes can mean the difference between recovery and lifelong disability. Viz.ai is one way Holmes Regional is meeting patients’ most urgent needs, but it’s not the only way.

B.E. F.A.S.T.  

All three of Health First’s community hospitals – Palm Bay, Cape Canaveral and Viera hospitals – and Holmes Regional Medical Center have refined their Stroke Alerts to shave minutes, even seconds off. The focus for physicians and directors is something called “door-to-needle time.” That’s how fast stroke patients are given Tenecteplase from the moment they enter the doors of the hospital.

For community hospitals, the average door-to-needle time today is 45 minutes.

Begin exploring your risk for stroke with Health First’s quick Stroke Risk Quiz, HF.org/Stroke.

 

Stroke is the leading cause of long-term disability in the U.S., and there are about 800,000 each year. The mnemonic Health First has adopted to help residents spot the symptoms of stroke is B.E. F.A.S.T.

■ Balance Is you or your loved one unsteady?
■ Eyes Is there vision loss?
■ Face Does the smile look uneven?
■ Arm Is one arm weak?
■ Speech Is speech slurred?
■ Time Time to call 9-1-1.

Don’t discount balance and vision symptoms – the B.and E. – says Whitney Adkins, Health First’s Neuroscience Program Nurse Manager. They’re associated with anterior and posterior strokes, which present in ways often confused with other conditions: 16% of anterior and 37% of posterior strokes are initially misdiagnosed.

And call 9-1-1, don’t settle for driving a loved one to the nearest Emergency Department (and never drive yourself). Paramedics and EMTs are trained to do initial diagnostic tests for stroke while enroute, and if positive, can begin the Stroke Alert process at Health First hospitals.