By Becky Wiese
Rural hospitals work diligently to provide the best health care they can to their constituents — many of whom are reticent to make the trip in to the hospital and often even less apt to call 911. “Not everyone wants to call 911,” explains Renee Kallevig, RN and director of the stroke program at Dr. John Warner Hospital in Clinton. “They may feel their symptoms are not serious enough, they don’t want another bill, a visit by EMS personnel is too much, or they think that their symptoms will go away eventually.”
But when a person is showing signs of a potential stroke, she explains that it’s imperative that they get medical care as soon as possible. “We are trying to encourage people to call 911 because that will get them the fastest service and the best care,” Kallevig says.
A patient has the right to decide on local evaluation and treatment such as at Dr. John Warner Hospital in Clinton, or a further destination large hospital. The good news for patients who may be suffering a stroke or brain bleed is that Dr. John Warner Hospital recently received the state mandated designation as an Emergent Stroke Ready Hospital (ESRH), meaning patients can get life-saving drugs administered within the 60 minute treatment time frame.
“We were always qualified [to treat stroke victims], but the ESRH certificate proves it and shows that we are ready to receive any patients with stroke-like symptoms,” explains Kallevig. She estimates that the hospital will see 35-40 strokes in a year.
The hospital went through a three-year process to earn the ESRH designation. Criteria includes having a written stroke policy, receiving training in drug administration from drug company representatives (including on-going quarterly education updates), agreements with other hospitals for neurology consult and care, creating an audit for the stroke process, and other administrative policies.
The result is that patients will benefit because the staff at Dr. John Warner Hospital is now better prepared to treat strokes. “Patients with strokes will be able to receive thrombolytics at DJW hospital more promptly. Also those with severe symptoms such as respiratory compromise will be resuscitated faster, rather than going an hour away prior to any treatment,” explains Dr. Jim Hubler, Director of Emergency Services. The staff can administer the medication to break up the clots, and then consult with a neurologist or neurosurgeon at a larger hospital for immediate transfer or follow-up care.
The designation is beneficial for patients who have not suffered a stroke as well. Dr. Hubler explains, “Patients with mild strokes or stroke mimics (diseases with symptoms which may mimic strokes: hypoglycemia and carpal tunnel, for example) can be evaluated and discharged without driving two hours away.”
Educating the public is an on-going priority. “We want anyone who has any stroke-like symptoms to preferably call 911 immediately or at least come to the hospital to be evaluated. We will never turn anyone away who is seeking treatment, even if they think it may be nothing,” says Kallevig.
Timing is crucial for treating strokes, as “time is brain” — meaning the longer treatment is delayed, the more damage that can be done due to the brain not receiving blood and oxygen, causing the cells and tissue in the brain to die. Once this happens, the damage may be irreversible and could result in paralysis to one side of the body, speech difficulties, and other functions we tend to take for granted.
Kallevig and other health professionals encourage patients to be aware of stroke symptoms such as:
• Dizziness
• Blurred vision
• Weakness on one side
• Facial drooping
• Slurred speech
• Altered consciousness (e.g., the person is disoriented or very confused)
• Extreme headache
• Unusually high blood pressure
A good mnemonic is FAST: Facial drooping, Arm weakness, Speech difficulties, and Time — call 911 immediately.
In addition, Kallevig is willing to come speak to groups to give presentations about stroke and stroke symptoms — free of charge. “We want everyone to be aware of the symptoms and understand the importance of immediate care,” she says.
As a designated ESRH facility, Dr. John Warner Hospital is now even better prepared to treat the people in their service area, increasing the likelihood for better outcomes to potential life-changing and, at times, life-threatening events.
Dr. John Warner Hospital has many programs to serve the needs of people living in the Dewitt County area including inpatient and outpatient services. For more information, you may contact Sandy Rice at 217-935-9571, ext. 3340.
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