Overton County EMS sharpened its stroke response this week through specialized training with Cookeville Regional Medical Center nurses.
The training focused on faster recognition, treatment decisions and hospital handoffs. Critical Care Paramedic and Shift Supervisor Shaun Hale II said local crews encounter suspected strokes frequently.
“The quicker you realize what’s going on and you can recognize that they’re having a stroke,” Hale said, “Getting them to proper care as quick as possible is some of the best treatment you can do for them.”
Hale said one of the critical decisions for EMS involves determining the appropriate destination for a stroke patient. Cookeville Regional serves as the closest primary stroke center and can treat certain blockages with clot-busting medication.
“If they can’t fix it, they would send you to a comprehensive stroke center, which deals with all strokes, all levels,” Hale said. “They have 24/7 care. They can deal with bleeds as well as blockages. And they usually have intensive care units for specialized patients, like stroke patients.”
Overton County crews can transport patients by ambulance to Cookeville Regional or, when weather permits, use air transport to reach a comprehensive stroke center in Nashville. EMS personnel can also alert the receiving hospital while still in the field.
“We would go ahead and notify Cookeville Regional that we have a stroke patient and we would give them details about the patient’s condition, when things started, how long it will take us to get there, what kind of deficits and issues the patient’s having,” Hale said.
Crews gather a patient’s history, the timing of the first symptoms and changes in the patient’s condition to give physicians information they can use upon arrival.
Hale said another challenge occurs before EMS ever reaches the patient. People sometimes dismiss stroke symptoms as fatigue or another medical problem, while other symptoms can disappear before a patient seeks help.
“Stroke symptoms that resolve pretty quickly, and that’s called a TIA, a transient ischemic attack, or as most laypeople call it, a mini-stroke,” Hale said. “Those, they have those symptoms, they resolve, and they’re like, ‘Oh, no big deal.’ That’s a precursor for a real stroke that’s coming. They still need to go get treated.”
Hale encouraged residents to remember BE FAST when checking for warning signs. The acronym represents balance, eyes, face, arms, speech and time. Warning signs include sudden loss of balance or coordination, vision changes, facial drooping, one-sided arm numbness or weakness and slurred or unusual speech.
“And then the T stands for time, which means you need to call 911 immediately,” Hale said.
Hale said the specialized instruction gives crews another opportunity to strengthen the process from the initial response through a patient’s arrival at definitive care.
“Training continues to sharpen our skills, make us be able to recognize the stroke faster, get them to the proper care,” Hale said. “It helps us to improve our protocols and ensure a faster and better patient transition process from EMS to the hospital or flight crews.”