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Alison Mynick, RN, Esq.
Alison Mynick, RN, Esq.
Contributor •

Weekend Medical Malpractice: Delay Places Stroke Victims At Risk

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Each year 700,000 American suffer the devastation of a stroke. About one third die, and many survivors suffer irreversible effects that limit speech and mobility.

You are fourteen times more likely to die of a stroke if you’re brought to the ER on the weekend.
A recent Canadian study outlines the startling figures, but the reasons why a weekend stroke patient is more likely to die than his or her weekday counterpart are still open to discussion.

What is known is the following basic fact: More than 80 percent of strokes are ischemic, not hemorrhagic.
Thrombolytic therapy has become a well established treatment in heart attack patients whose coronary artery is blocked by a clot. However, clot dissolving thrombolytic therapy is not so generally used in a “brain attack” involving a clot. One catch is that the stroke has to be diagnosed and treatment with the drug initiated within three hours of the stroke for thrombolysis to be effective.

In the best case weekend scenario, an observant bystander will do everything right: recognize face weakness or numbness, droopy mouth or crooked smile, notice slurred speech or someone’s difficulty understanding simple language, and call 911.

Weekend ER physicians and nurses need to bump “brain attack” victims to the front of the triage line, have them promptly CT scanned and look at the results on an “emergent” basis.

(For more information see “Weekends Worst Time for Stroke”

Each year 700,000 American suffer the devastation of a stroke. About one third die, and many survivors suffer irreversible effects that limit speech and mobility.

You are fourteen times more likely to die of a stroke if you’re brought to the ER on the weekend.
A recent Canadian study outlines the startling figures, but the reasons why a weekend stroke patient is more likely to die than his or her weekday counterpart are still open to discussion.

What is known is the following basic fact: More than 80 percent of strokes are ischemic, not hemorrhagic.

In other words, for 80 percent of the stroke victim population, the problem is that the brain’s blood vessel is blocked by a clot, not damaged by leaking blood. That’s important because stroke victims who have a clot blocking the flow of blood to the brain can be given the chance to take a clot busting drug that dissolves the clot.

Thrombolytic therapy has become a well established treatment in heart attack patients whose coronary artery is blocked by a clot. However, clot dissolving thrombolytic therapy is not so generally used in a “brain attack” involving a clot. One catch is that the stroke has to be diagnosed and treatment with the drug initiated within three hours of the stroke for thrombolysis to be effective.

In the best case weekend scenario, an observant bystander will do everything right: recognize face weakness or numbness, droopy mouth or crooked smile, notice slurred speech or someone’s difficulty understanding simple language, and call 911.

But if the stroke victim pulls into the ER ambulance bay within an hour of the stroke, then sits unattended on a gurney for an hour, or is made to wait in line for a CT scan (used to tell whether it is a clot type stroke as opposed to a leaking vessel stroke), and then waits another hour or more for the scan to be read and digested by doctors, the window of opportunity is gone forever.

It stands to reason that lengthy ER triage delays, patients backed up in the ER because their primary physician’s office is closed for the weekend and lower staffing will negatively affect the small but critical window of opportunity to benefit from thrombolytic therapy.

Weekend ER physicians and nurses need to bump “brain attack” victims to the front of the triage line, have them promptly CT scanned and look at the results on an “emergent” basis.

(For more information see “Weekends Worst Time for Stroke”