Health Check: New EMS stroke protocols


New Emergency Medical Service stroke protocols in Rhode Island are saving lives.

George Tremblay, of Charlestown, living proof.

He had a stroke on May 23, 2017.

"We're moving plants and moving stuff down to the front of our property," said Suzanne Tremblay, his wife of 38 years.

"At one point, getting on and off the tractor, I couldn't remount the tractor,” said George. “And when I tried to talk to her, I couldn't speak coherently and I then I just slid to the ground."

George was assessed by first responders.

"We use what is known as a Los Angeles motor scale, which is a severity score and basically that's based on facial droop, arm drift, and grip strength,” said John Potvin, who is the chairman of the Rhode Island Ambulance Service Advisory Board.

Potvin, along with the Department of Health, instituted the new protocol, last March.

George had the maximum score of five and was rushed to the only comprehensive stroke center in Rhode Island, which is Rhode Island Hospital.

"It’s a dramatic increase in good outcomes by coming to the right hospital the first time," said Dr. Mahesh Jayaraman, who is the director of the Neurovascular Center at Rhode Island Hospital. "We recognize while most strokes are minor strokes there's a subset of strokes that are severe strokes, maybe 20 percent or so."

George had a major blockage, which dictated he be brought directly to Rhode Island Hospital where they performed a procedure known as a thrombectomy.

"We put a small hollow plastic tube called a catheter, typically through an artery in the leg would go up to where the blockage is and we use a small metallic device and grab the clot and pull the clot out of the artery of the brain," said Jayaraman.

Within an hour of arriving at the hospital, George’s clot was removed.

"And about two hours later in the recovery room, George was almost back to normal," said Jayaraman.

"I was ready to go home,” said George, who was not quite ready to be released. “It was unbelievable."

The successes of this new protocol can be measured, said Jayaraman, who along with his colleague, Dr. Ryan McTaggart, recently presented their findings at the International Stroke Conference.

"What we showed is that in the state of Rhode Island for patients with severe stroke who are closer to a primary stroke center but drive the extra time to get to a comprehensive stroke center, the time to the angiogram, the treatment with the retrieval of the clot is cut by almost an hour,” said Jayaraman.

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