Alberta hospitals lead world in treatment time for stroke patients

Florence Deschamps gets emotional when she recounts suffering a stroke in her home near Ma-Me-O Beach in February 2016. The 73-year-old woke up that morning with a pain in the back of her head, but continued to help her nine-year-old granddaughter get ready for school. “I thought the pain was the way I slept,” recounts Florence, but then suddenly she felt dizzy and collapsed. Her son Dale called the ambulance and she was rushed to the Grey Nuns Community Hospital.

Florence Deschamps, 73, is fully enjoying life after suffering a stroke in February 2016, thanks to being administered a clot-busting drug quickly.

“It has been really overwhelming for me because when I was in intensive care I thought I was going to die,” Florence says, her voice quavering. “The way they took care of me, what the doctors and nurses did, it wasn’t anything short of a miracle. I was able to move myself almost immediately.”

The Grey Nuns has the fastest door-to-needle time in the Edmonton region—on average 29 minutes—and holds the record for the quickest time in the province at six minutes. The stroke response team, made up of physicians and staff from the emergency department and diagnostic imaging, work together to give patients suffering from an ischemic stroke the clot-busting drug tPA (tissue Plasminogen Activator). There are 20 steps in the process before a patient receives the drug. Florence’s neurologist, Dr. Muzaffar Siddiqui, says she received tPA within 20 minutes.

“The minute a patient hits the door to when they leave—our team is very passionate about their care,” says Muzaffar. “These types of gratifying outcomes are what we aspire to.”

Door-to-needle times for stroke patients

Alberta is leading the world treating ischemic strokes thanks to the provincial quality improvement initiative QuiCr (pronounced "quicker"), Quality Improvement & Clinical Research – Alberta Stroke Program. Dr. Thomas Jeerakathil, Neurologist and QuiCr Co-lead, says stroke teams initially targeted a 45-minute door-to-needle time—the time a patient arrives at the hospital to when they receive the drug. To date the average time has fallen provincewide from 70 minutes to 32 minutes.

“Our ultimate goal is 30 minutes,” says Thomas. “I initially thought it was a pipe dream.”

(From left) Dale Saddleback, Florence’s son; Florence Deschamps, stroke patient; and Dr. Muzaffar Siddiqui, Florence’s neurologist, met a year after Florence’s stroke to talk about her successful recovery.

Dale Saddleback says he was stunned by his mother’s recovery. The drug almost immediately restored movement to her left side.

“Science and technology have not always been best friends of Indigenous people—I was sure grateful it was there; it elongates our time with her,” says Dale.

For Florence, every day is a gift. She has been through a lot in her life and takes nothing for granted. She credits her family, her culture and faith, her determination and the care she received, particularly from Muzaffar.

“He was there when I first opened my eyes,” says Florence, wiping a tear from her eye. ”He never left me.”

“For my mother this is a heavy experience. We are very grateful,” says Dale. “You could almost feel love; we never experienced that before in other hospitals.”

Florence says she still needs some assistance with walking and has a little bit of drooping on the left side of her face when she is tired, but that isn’t stopping her from soaking up all the richness life has to offer.

 

Door-to-needle. Signs you are having a stroke.

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