Stroke Care Video: Sharp Grossmont Hospital

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Transcript

EMT: We got a call to the home of a 76-year-old male patient; per the wife here all of a sudden his speech became very slurred and he just crumpled to the ground.

Sue: Copy, does he have a facial droop?

EMT: It’s hard to tell because we have him laying on his back. We’re trying to get him to smile but he just opens his mouth real wide.

Sue: Hi, it’s Sue in the ER, I have a stroke code. Your run number 2404813. Seventy-six years old, slurred speech. Slumped to the ground. Can we get a name? Harold Bentley. We got there, he was sitting against his wall.

Dr. Braheny: The quicker the strokes can be treated, the better outcome we can expect. Heart rate 76.

Dr. Braheny: Stroke is a sudden injury to the brain caused either by a blood clot clogging a blood vessel, or a burst blood vessel causing a hemorrhage or bleeding in the brain. Can you smile for us? Can you smile real big?

Dr. Braheny: There’s only one drug that is FDA-approved to treat stroke, and that’s TPA, or tissue plasminogen activator and that dissolves clots.

Nurse: A nice deep breath, sir. Sir. Let’s go to CT.

Dr. Braheny: It’s the strongest medication we have when used early. However, we can’t use it beyond three hours of onset of symptoms. The CT scan is primarily done to rule out a hemorrhage, because you don’t want to treat a hemorrhage with blood clot busting agents. They wanted to do TPA, there’s just no waiting around at all. Hi, I’m Dr. Braheny, can you open your eyes? Mr. Bentley? Can you hear me?

Nurse: OK and what you’re going to do…

Dr. Braheny: Mr. Bentley? Can you see this picture?

(gibberish)

Dr. Braheny: Well, how about this?

(gibberish)

Dr. Braheny: He is aphasic, he has trouble getting the right words out, some of them are gibberish, nonsense words, so he’s in danger of losing his ability to speak. That would mean he would completely lose his independence. I’d like to check your strength. Hold that arm. One, two, three, four, five, six, seven, eight, nine, ten. Can you hold that one up? Hold it up there. Hold it. One, two, three… It’s a little bit of a drift on one side so he may have a mild weakness. I cannot give TPA without a history. Here’s our TPA. So the family members’ input was crucial. We’re good to go, 9:54. Just try and relax a little bit Harold. It’s in! The first week after the stroke, you’re still at higher risk to have another stroke, so it’s a very unstable situation.

Michele: This morning he was very disoriented, very dizzy, stumbling around, and that’s just not like him. The first thing that went through my mind was stroke. I knew time was of the essence and thank God he got brought here.

Sue: And my message would be that, call 911. Even though the thought seems to be, I can get you into the car and get you there quicker, something could happen in that car, suddenly the person next to you collapses. How are you going to manage that? Anybody could treat a stroke, but we are the certified stroke center, so those medics know they need to start heading towards Sharp Grossmont. I’ve got resources at that bedside and they are waiting for that stroke code to come in. Stroke symptoms, 911. Time! The clock is ticking.

Michele: He called my mother this morning and it freaked her out a little bit because, you know, phone rings at 5:45 in the morning. It was him. “Where’s my glasses?” and “Where’s my car?”

Harold: And every time they come by everybody asks the same questions: how are you feeling, are you better yet, and put your hands out like this for 10 seconds. Yeah, OK. Do that for 10 seconds on your ankles or something.

Michele: Rub your stomach and pat your head.

Harold: Oh yeah, it’s just one right after another.

Michele: Well it’s amazing. Even 24 hours, a remarkable difference. He’s so coherent now, it’s just unbelievable. When we were chatting with the nurses last night, just about his condition out here, he says from the other room, “be quiet out there,” like OK, Dad’s back. He’s doing remarkably well. I think he’s going to bounce back. He’s definitely motivated; he’s got grandkids to live for.

Granddaughter: Where does the catcher sit for dinner?

Harold: I don’t know.

Granddaughter: Behind the plate.

Harold: Oh, behind the plate, OK.