Helping patients with stroke: The rapid response team

If you ever come to the emergency department (ED) of Sharp Grossmont Hospital due to a stroke, some of the first people you encounter may be staff from the Rapid Response Department. This team, comprised of registered nurses, helps lay the groundwork for receiving and triaging — or assessing — patients with stroke.

“When a patient with stroke arrives in the ED, a stroke code is called,” says Dayle Gates, a registered nurse and clinical lead for the Rapid Response Department at Sharp Grossmont Hospital. “My team responds to the code immediately.”

For Gates and the rest of the rapid response team, the saying, “time is brain tissue” is their motto.

“We have a very narrow window of time in which we can treat patients,” says Marilou Cabusao, a registered nurse and supervisor in the Sharp Grossmont Rapid Response Department. “The longer a patient goes without treatment, the higher the chance for serious and permanent brain damage, which can affect a person’s ability to function.”

Acting quickly with care and compassion

To give a patient the best chance of retaining their functions, the rapid response team acts quickly to:

• Gather information from family, nursing homes or other caregivers so that doctors can review the information to determine whether a patient is eligible for treatment.

• Determine when the patient was last known to be functioning well, and how well they were functioning.

• Act as a team leader when communicating with doctors and nurses.

• Cross-check the stroke code processes to make sure they are followed correctly.

“From the time patients arrive in the emergency room, to their admission to the stroke unit, our team follows the patient's journey through each individual department involved in stroke care,” says Matthew Dolstein, a registered nurse in the Rapid Response Department. “For instance, we are present for the initial triage, then accompany the patient to imaging, then liaison between the emergency room physician and the neurologist.”

According to Dayle, the entire stroke process is a collaboration, from prearrival to discharge. The team often acts on very short notice, with everyone ready to respond.

“From the time the patient arrives — either via ambulance or brought in by loved ones — it's a group effort by physicians, nursing, pharmacy, health care partners, imaging and laboratory,” Gates says.

Adding others to the care team as needed

If a patient qualifies for thrombectomy (a surgical procedure to remove a blood clot), the patient’s care team then widens to include interventional radiology staff and doctors, anesthesiologists, additional nurses and the surgical intensive care unit team. “The stroke process includes almost every single department in the hospital,” Gates says.

Along with assessing patients in the emergency room, the team also works throughout the hospital to help stroke patients during their inpatient stay. Whether within the hospital or in the emergency room, the rapid response team is a nimble and highly skilled group.

“It has been really satisfying to witness and be a part of how our processes have evolved over the past four to five years,” says Gates. “I really appreciate the relationships we've built with the neurology and emergency department physicians. And of course, I appreciate my coworkers. I feel like we are a small, but mighty team.”

For Dolstein, there is a spiritual drive when caring for his patients. He says he most appreciates getting to be with patients in what may be their most difficult hour. “I enjoy the privilege of caring for them as a whole person by providing medical and spiritual care during their hour of need,” he says.

Learn about Sharp Grossmont Hospital’s designation as a Comprehensive Stroke Center — the highest designation given by The Joint Commission in association with the American Heart Association/American Stroke Association.