Stroke signs and symptoms:
- Weakness – Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary.
- Trouble Speaking – Sudden difficulty speaking or understanding or sudden confusion, even if temporary.
- Vision Problems – Sudden trouble with vision, even if temporary.
- Headache – Sudden severe and unusual headache.
- Dizziness – Sudden loss of balance, especially with any of the above signs.
Niagara District Stroke Centre
A program of the Niagara Health System, the Niagara District Stroke Centre is a regional service that has developed several programs for both acute stroke and TIA. The District Stroke Centre works with a number of provincial partners to ensure the care in Niagara meets best practice standards. “Pre-hospital and ER treatment, diagnostic testing, inpatient care, rehabilitation and follow-up counselling form a care continuum and need to be fully integrated so patients will have the best outcome possible,” says District Stroke Centre Co-ordinator Leanne Hammond.
Over the past several years, the District Stroke Centre, located at Greater Niagara General Site in Niagara Falls, has worked closely with Base Hospital, which implements the provincial paramedic prompt card, ensuring all Niagara residents are assessed and directed to the appropriate centre. Stroke protocols have been put in place, so that all 911 calls resulting in suspected stroke patients come by ambulance to Greater Niagara General (GNG) Site if they meet the criteria for tPA, a clot busting drug for stroke. Part of the protocol involves notifying the ER in advance, so the dedicated stroke team is gathered when the ambulance arrives with the patient.
The ER Stroke Team
“We have an excellent ER stroke team at GNG, and our nursing staff and emergency doctors are keen to keep their stroke care training up-to-date so that we can deliver the best stroke care possible in the shortest amount of time,” Leanne says. “Leading this is our Medical Director Dr. Don Chew, a Niagara Falls Neurologist who has been a strong advocate for best practice stroke care, and Acute Stroke Nurse Practitioner Marie Rusnak.”
The sooner a patient gets to the GNG ER, the better the chance that they will be able to receive tPA, the clot-busting drug that can drastically improve a stroke patient’s outcome. “There is a limited amount of time – three to four hours – from the onset of symptoms when we can inject tPA, so as soon as stroke symptoms present, it is vital to call 911 immediately,” Leanne says.
New Regional Acute Stroke Unit
If a patient has suffered an acute stroke, a brand new Regional Acute Stroke Unit at GNG will be their resting place for up to 10 days. This 10-bed unit opened on Unit D in May 2010, and for the first time in Niagara, acute stroke patients are clustered so that the healthcare team can better co-ordinate care and therapies. “Speech therapy, Occupational Therapy and Physiotherapy are just a few of the treatments that are important in the first few days following a stroke,” Leanne explains. It is key to begin rehabilitation as soon as possible.
After discharge home or transfer to Hotel Dieu Shaver Health and Rehabilitation Centre for rehab services, various other programs are available for aftercare.
A Doppler test is a non-invasive ultrasound test that shows the condition of the carotid artery in the neck.
Niagara Stroke Prevention Clinic
One active program is the Secondary Stroke Prevention Clinic for patients who have had a TIA. “A TIA can be a precursor to an impending acute stroke so we must address risk factors as quickly as possible,” Leanne says. “The most effective treatment is prevention and our mission with this clinic is to provide rapid access to assessment, diagnostic testing and treatment for clients identified as high risk for stroke.” Referrals to the Stroke Prevention Clinic can be made by a family physician, walk-in clinic physician or an emergency physician. A primary goal is to fast track testing (CT scan and Doppler test within 48 hours) and an initial consultation with a Neurologist/Physiatrist. At the same time, evaluations are made to determine the degree of risk for future stroke, consultations are booked with a Nurse Practitioner and Dietitian and health teaching gets underway.
Referrals to the Stroke Prevention Clinic can be made by a family physician, walk-in clinic physician or an emergency physician. A primary goal is to fast track testing (CT scan and Doppler test within 48 hours) and an initial consultation with a Neurologist/Physiatrist. At the same time, evaluations are made to determine the degree of risk for future stroke, consultations are booked with a Nurse Practitioner and Dietitian and health teaching gets underway.
Stroke Specific Adult Day Service
In Niagara Falls, through the Region of Niagara, a Stroke Specific Adult Day Service Program now provides individual programming in a comfortable, safe, secure and homelike setting for adults who have had a stroke. Located at Fairhaven Apartments, the Fairhaven Adult Day Service Program is focused on prevention, minimizing impairment, reducing activity limitations, and maximizing the participation and quality of life. The Day Services provides respite care and information for caregivers. Clients are referred to the Fairhaven Adult Day Service Program by Community Care Access Centre, Niagara Health System, Hotel Dieu Shaver and Family Physicians.
For more information please contact – 905-378-4647, ext. 55556.
The Canadian Stroke Network has a number of publications listed on their website. Take a moment and visit them.