AAMC Magazine

Spring 2007

AAMC is Your Certified Stroke Center

Surviving a stroke with minimum complications can be greatly increased if symptoms are acted on quickly and tPA, a clot-busting medication, is administered in the first three hours after onset of symptoms.

Dolores Pumphrey knew something was dreadfully wrong when she couldn’t find her glasses one December morning. “I was on my way to physical therapy for arthritis in my leg and back, and I knew something just wasn’t right with me,” the 67-year-old Lothian resident said. “I felt the best I’d felt in a long time, but I wasn’t quite right.” There was no one at home with whom she could share her uneasy feeling.

She gave up her search and wore her prescription sunglasses instead and drove herself to her appointment in Edgewater. As she signed the register, a receptionist greeted her and frowned at the garbled response she received. A short time later, Mrs. Pumphrey was on her way to Anne Arundel Medical Center in an ambulance, a probable stroke patient.

For many people, the key to surviving a stroke with minimum complications is acting on the symptoms quickly and receiving a clot-busting medication that can reduce the effects and possibly prevent permanent disability.

Recently certified by The Joint Commission as a stroke center—the only such center in the region—AAMC has specially trained staff to administer this clot-busting drug called tPA, tissue Plasminogen Activator. This medication is approved for use in certain patients having a heart attack or stroke. According to the American Heart Association, tPA must be given no later than three hours after symptoms begin. The drug is administered through an intravenous line.

The Joint Commission certification means AAMC has demonstrated that its stroke program follows national standards and guidelines that can significantly improve outcomes for stroke patients. According to the Maryland Institute for Emergency Medical Services Systems, someone is hospitalized for a stroke every 30 minutes and someone dies every three hours in Maryland.

Patient Dolores Pumphrey meets with Emergency Room physician Dr. Ken Gummerson and neurologist Dr. Jackie Syme two months after they and a specially trained team treated her for stroke.

Already an accredited health care facility by The Joint Commission, AAMC independently sought out the certification of its Stroke Center program.

Cardiologist Mitchell Schwartz, M.D., executive director, Clinical Program & Business Development, emphasizes that “stroke patients need to be treated in a time-sensitive framework just as heart attack patients do. It takes coordination among a multitude of nurses, staff and physicians. AAMC demonstrated its capability to deliver this time-sensitive, orchestrated care for stroke patients.”

In addition to the physicians and nurses who see the patient in the Emergency Room, the stroke care team includes neurologists, radiologists, radiology technologists, laboratory personnel and secretaries who move the medical orders in a timely manner. If a patient is admitted to the Medical- Surgical Unit, a hospitalist—a physician who sees and treats other physicians’ hospitalized patients—will oversee the patient’s care. If the patient is admitted to the Critical Care Unit, an intensivist cares for the patient.

Because the symptoms of a stroke may include confusion or difficulty with speaking or comprehension, it often is a family member or co-worker who recognizes there is a problem.

Laura Norton, R.N., M.S.N., stroke program coordinator at AAMC, says community education is the vital link in raising awareness about the symptoms of stroke. “Our care begins when the patient arrives,” she says. “But our responsibility begins with outreach and education efforts that will help ensure patients arrive here as soon as possible after the onset of a stroke.”

A Great Outcome

Mrs. Pumphrey arrived at the AAMC Emergency Department at 10:58 a.m. and was examined by Emergency Room medical director Ken Gummerson, M.D., then by neurologist Jackie Syme, M.D., medical director of the stroke program. After an evaluation and a workup that included a Computed Tomography (CT) scan and blood work, the medical team determined that Mrs. Pumphrey was a candidate for tPA. The drug was administered at 12:08 p.m. She received treatment well under the rigid, three-hour window of opportunity.

“I started to feel better almost right away,” Mrs. Pumphrey said. She was taken to the Critical Care Unit, where she stayed for one day. “I was home the next day. I am truly blessed.”

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