The Newsletter for SUNY Downstate
University Hospital of Brooklyn
ISSUE 8 MAY 2013
Downstate Wins GOLD PLUS Achievement Award for Stroke Care
Earlier this month, SUNY Downstate received the American Heart Association/ American Stroke Association's Get with the Guidelines-Stroke GOLD PLUS Quality Achievement Award. This is the second year in a row that Downstate has been recognized by the joint associations for quality stroke patient care and outcomes.
Such recognition means a great deal to the physicians, nurses, technicians, and researchers who are part of the Downstate Stroke Center team. But it means even more for the people of Brooklyn.
The chance of surviving a stroke without serious long-term disability greatly depends on how quickly a patient can receive emergency care at a hospital that specializes in stroke. Downstate has been designated a Primary Stroke Center by the New York State Department of Health.
As one of the most advanced centers for the diagnosis, management, prevention, and research on stroke and cerebrovascular disorders—and the only academic hospital and clinical stroke research center in Brooklyn—Downstate specializes in managing complex cases, and targets interventions to meet each patient's select needs. In addition, Downstate is the only hospital in Brooklyn that is part of the NIH's Neurological Emergencies Treatment Trials network, a collaboration that provides Downstate patients access to promising therapies and national clinical trials.
As soon as a patient arrives in the ER, the stroke team begins rapid, coordinated actions to determine the type of stroke and its treatment. A stroke can be caused by a blocked blood vessel to the brain (known as ischemic stroke) or a burst blood vessel (hemorrhagic stroke).
"Sometimes people experience a transient ischemic attack that lasts only minutes, but prompt diagnosis and treatment can prevent a future major stroke," says Alison Baird, MD, medical director of the Stroke Center and director of the Division of Cerebrovascular Disease and Stroke.
As a NYS Designated Stroke Center, Downstate must meet certain benchmarks for speedy delivery of care.
Door to MD — 10 minutes
Door to Stroke Team — 15 minutes
Door to CAT Scan — 25 minutes
Door to Reading CT — 45 minutes
Door to Needle Time — 60 minutes (tPA therapy)
"Within 24 hours of admission, patients are assessed to determine the etiology of stroke and what type of acute rehabilitation is necessary," explains Sherene McIntyre, NP-C, Stroke Center Coordinator. Physical, occupational, and speech therapy, as well as medications, are provided to help restore a patient's functions.
Following a stroke, patients often develop spasticity in their limbs. "For many, it is difficult to open and close their hands or get dressed without help," says Susan Law, MD, a UHB Stroke Fellow. "We have found that Botox is extremely effective, even five years after a stroke. I have patients who are so happy they can finally button a shirt."
Throughout UHB, there is strong emphasis on secondary stroke prevention. Each year, some 180 nurses at Downstate receive special training in acute stroke assessment, treatment, care, and patient education. And to make sure that the community is informed, members of the Stroke Center frequently attend church gatherings and community fairs, as well as workshops held on campus. The need for better stroke awareness and prevention is very great in Brooklyn.
"Central Brooklyn is a hot spot for ischemic stroke," explains Dr. Law. "In addition to genetics, other known risk factors for stroke—such as hypertension, diabetes, high cholesterol, and obesity—are prevalent in the African- and Caribbean- American communities we serve."
"Both at the Stroke Center and through our community outreach, we aim to teach Brooklyn residents how to recognize the symptoms of stroke and get help fast, as well as make lifestyle changes that may prevent future occurrences," says Dr. Baird.