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L.A. County starts using stroke centers

November 17, 2009|Rong-Gong Lin II

Paramedics on Monday began transporting suspected stroke victims in Los Angeles County to the nearest certified stroke center, a change that officials hope will save lives and brings L.A. into line with other urban counties in the state.

The policy shift will route patients to 10 hospitals, including one in Orange County, that have a specialized stroke neurologist available at all times.

Those facilities can run blood tests and brain scans, as well as offer rehabilitation services, said Dr. Bill Koenig, medical director at the L.A. County Emergency Medical Services Agency.

For stroke victims to benefit from the change, however, physicians say the public needs to be aware of stroke symptoms in case their co-worker or loved one starts to show them, and immediately call 911.

For The Record
Los Angeles Times Wednesday, November 18, 2009 Home Edition Main News Part A Page 4 National Desk 1 inches; 48 words Type of Material: Correction
Stroke centers: An article in Tuesday's Section A on Los Angeles County's decision to direct suspected stroke patients to specialized stroke centers said Dr. Samuel Stratton is medical director of the L.A. County Emergency Medical Services Agency. He is medical director of Orange County's Emergency Medical Services department.

The five "sudden symptoms" of stroke are weakness on one side of the body, severe headache and difficulty speaking, walking or seeing.

In general, hospitals have less than three hours after the beginning of stroke symptoms to begin aggressive treatment of a blood clot in the brain.

Unfortunately, many stroke victims are either unaware that they are having a stroke or are hoping that their symptoms will go away.

If stroke victims are not within 30 minutes from a stroke center, they will be directed to the nearest hospital.

"In the past, when stroke was not really a treatable condition, it didn't really matter which hospital you went to," said Dr. Jeffrey Saver, who heads the stroke center at UCLA. "But now we have proven therapies . . . and we want patients to go to the right hospitals."

Advances made over the last 15 years include medication that can dissolve a clot that blocks blood flow in the brain.

"We're fighting for time. We're trying to save the brain," said Dr. Lance Lee, head of the stroke center at Glendale Adventist Medical Center. The philosophy of stroke centers, which is promoted by the American Heart Assn., is similar to the idea behind trauma centers -- to designate hospitals that are better able to handle specialty care.

In 2006, L.A. County launched a system for heart attacks, in which paramedics transport victims to hospitals able to do emergency angioplasties that restore blood flow to the heart.

Hospitals now designated to handle strokes leave South Los Angeles, San Gabriel Valley and Antelope Valley underserved but, officials said, they believe that other facilities will seek certification.

Early results in Orange County, which had nine hospitals designated as stroke centers in April, have been promising.

In 2006-07 statewide, only 4% of patients with blood clots in their brain received treatment to reverse the stroke.

Between April and September in Orange County, 29% of patients with blood clots in their brain received them, said Dr. Samuel Stratton, medical director of the L.A. County Emergency Medical Services Agency.




Treatment centers

Certified stroke centers for Los Angeles County patients:

* Cedars-Sinai Medical Center

* Glendale Adventist Medical Center

* Long Beach Memorial Medical Center

* Northridge Hospital Medical Center

* Presbyterian Intercommunity Hospital (Whittier)

* Providence Little Company of Mary Medical Center -- San Pedro

* Providence Saint Joseph Medical Center (Burbank)

* Ronald Reagan UCLA Medical Center

* Torrance Memorial Medical Center

* Los Alamitos Medical Center (Orange County)

Source: L.A. County Emergency Medical Services Agency

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