By Lance Lee, MD, Stroke Medical Director
The Neuroscience Institute at Glendale Adventist Medical Center

Stroke is a medical emergency that occurs when there is an interruption in blood supply to brain tissue caused by a blockage or a rupture of a blood vessel. Stroke treatment can be complex, with some treatments being life-saving to one patient but deadly to another depending on the type of stroke and the patient 's medical history.

According to the American Stroke Association, severity ranges from mild impairment to irreversible neurologic damage, which may result in permanent disability or death. Stroke remains the third leading cause of death and the leading cause of adult disability in the United States.

The goal of a Stroke Center is to improve patient outcomes through an organized system of care.

This may sound like a simple task, but implementing a full-service Stroke Center involves a high level of complexity in organizing standardized protocols, physician resources, nursing education and training, patient education and technological support.

The development of a Stroke Alert Team is a vital part of a stroke center; it is a triage mechanism that allows rapid identification and intervention with thrombolytic drugs for stroke patients who arrived less than three hours from symptom onset.

Effective clinical decision making is critical to ensure the best treatment is selected for the clinical situation and promptness of acute interventions for improved patient outcomes and quality patient care.

Glendale Adventist Medical Center 's Stroke Alert was launched in October 2007. If there is a patient with suspected acute stroke, stroke alert is activated by calling 6464 for immediate evaluation by the Stroke Alert Team.

Members of the Stroke Team include the neurologist on call, stroke coordinator, CT tech, pharmacy, laboratory, house supervisor, ED staff and neuro telemetry nurses.

Our team of physicians and stroke specialists are dedicated to ensuring that the amount of time that passes between stroke and treatment is minimal. Our goal is to diagnose and treat a person showing symptoms of stroke within an hour to two hours of arrival at Glendale Adventist Medical Center.

Regardless of how an acute stroke patient enters the hospital, Glendale Adventist Medical Center 's Stroke Alert Team is ready to respond 24 hours a day, seven days a week.

Each member of the team is highly trained and performs a critical function, resulting in faster treatment times and, ultimately, better outcomes and shorter hospital stays.

Each member of the Stroke Alert Team has a particular role to play in order to follow the timeline set in the algorithm.

Coordination between the hospital and emergency medical service.

Immediate CT scan and laboratory results within the 45-minute window in order to plan for the next step in the treatment process.

Neurosurgical services are available to stroke patients within two hours of when services are deemed necessary.

The stroke neurologist can refer patient to a neurointerventional radiologist for other treatment options if the three-hour window for tPA has passed and if the patient does not meet the criteria for IV tPA

Written procedures are designed to accelerate the diagnosis and treatment of stroke patients.

Glendale Adventist Medical Center also has a specialized stroke unit where patients can receive monitoring and care beyond the initial life-threatening period.

A multidisciplinary team of experts coordinates the individual care of each patient, ensuring that their physical, behavioral, cognitive and emotional needs are met.

There is a Neurology Stroke Call Panel responding 24/7. There is also an Internal Medicine Stroke Call Panel to address other medical problems exhibited by stroke patients.

The team is looking into best practice guideline for development of in-house Stroke Alert.

Even as technology and techniques in the treatment of stroke continue to evolve, the most important factor to remember with stroke is time.