At 2:12 pm, a young lady runs into the hospital waiting room and asks for a wheelchair. The Volunteer manning the Gift Shop asks if she needs help with someone in her car. The young lady responds that her mother can’t talk and she can’t move one side. The Volunteer immediately calls the Emergency Department Nurses Station and tells them there is a lady needing a wheelchair for a family member in the car that may be having a Stroke. About a minute later, the Nurse has come by with a wheelchair and the young lady is on her way to the car with him.

The Nurse asks the patient her name and she does not speak normally;  her words are somewhat abnormal and her mouth seems to be having a droop on the side of her mouth and when she tries to stand, the right arm and leg don’t work; they are flaccid (unable to move on their own). The Nurse is thinking the right side is weak and she can’t speak correctly; may be dealing with a left sided brain stroke: 2:15 pm.

The Nurse asks the patient’s name as they go by Registration Desk and asks the daughter to give admission information to the clerk, then, come see the Nurse about medications. The Nurse goes on into a patient room, helps her onto a gurney, and performs Vital Signs; all are within normal limits except the Blood Pressure is a little high at 162/87. The Nurse performs a quick Stroke Assessment asking her to stick her tongue out which moves to the left; hold her arms out in which she can barely move her right arm; wiggle her feet in which the patient cannot move her right toes or leg. The patient is asked to repeat a short sentence in which the patient can say some words, but are not in the right order or garbled. The Nurse alerts the Nurses Station and tells the Doctor that there is a new patient with a probable CVA (Cerebrovascular  Accident, or Stroke). 2:21 pm. 

About that time, the daughter comes around the corner heading to her mother’s room and the Doctor asks her “when was the last time you saw your mother when she was talking normally and didn’t have the flaccid arm and leg”. She told him she went down for a nap about 1 o’clock. Realizing that there is a 3 hour time frame to give a clot buster (hemolytic drug), the patient was still in a good timeframe. 2:23 pm.

The Doctor asked the Nurse to order a CT Scan (computerized tomography) of the Head to make sure there was no bleeding in the brain area (if there is bleeding, the patient may have Stroke symptoms from the bleed, and also to clear the patient such that if there is no bleeding identified, the patient may be eligible for a clot busting drug.) The Nurse orders for a CT Scan of the head and other Lab Tests while the Doctor is getting a list of the patient’s medications from the daughter. 2:25 pm.

The X-ray Tech goes out to the CT Scanner and warms it up for the patient while blood is being drawn. Cardiopulmonary Department has been called to do an EKG to make sure the patient is in a normal heart rhythm. 2:27 pm.

The patient is taken to the CT Trailer and the scan is performed. The blood tests are being run and the EKG appears to be Normal. The patient returns from the CT Scanner. 2:35 pm

Rather than wait for the results to be officially read by a Radiologist off site, the Emergency Room Doctor has experience with reading X-rays and goes to the X-ray department to look at the CT Scan. Seeing no bleeding in the brain, ruling out that the patient has taken any medication or food that would contradict the giving of a thrombolytic drug, the Doctor orders the Transfer of the patient to a Stroke Facility. The Transfer Center called back and said that they would not be able to transport the patient for about 45 minutes. 2:43 pm.

The experienced Doctor stated that it would be fine and ordered the Nurse to mix and give the patient the Clot Buster medication. There being only a 3 hour window to give a thrombolytic agent, it was better to give the needed treatment at Orchard Hospital rather than wait for time to run out waiting for Transportation. The Medication was given. 2:45.

Time is of the essence. 33 minutes is the average time in the Emergency Room needed to stabilize and get the patients the care that they need.

Vote “Yes” on Measure M to keep these Emergency Services available at your local hospital.