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The Canadian Stroke Network found that less than half of Canadians who've experienced more than three hours of stroke symptoms will receive a CT or MRI scan within an hour of arriving at a hospital. Dr. Mark Bayley, the medical director of Toronto Rehab's Neuro Rehabilitation Program, speaks with CTV News on Thursday, June 16, 2011. An ambulance leaves the scene of a water rescue at Breezy Point Friday night.

Hospital care for stroke victims lacking: report

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A doctor discusses the study, which reveals stroke victims are not getting to the hospital quickly enough and aren't getting treatment fast enough, and explains what the signs of a stroke are.
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The senior physician at Montreal General Hospital explains what the signs and symptoms of a stroke are, and talks about why people are waiting to go to the ER when suffering those symptoms.

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The Canadian Stroke Network found that less than half of Canadians who've experienced more than three hours of stroke symptoms will receive a CT or MRI scan within an hour of arriving at a hospital. Dr. Mark Bayley, the medical director of Toronto Rehab's Neuro Rehabilitation Program, speaks with CTV News on Thursday, June 16, 2011. An ambulance leaves the scene of a water rescue at Breezy Point Friday night.

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The Canadian Stroke Network found that less than half of Canadians who've experienced more than three hours of stroke symptoms will receive a CT or MRI scan within an hour of arriving at a hospital.

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Date: Thu. Jun. 16 2011 5:41 PM ET

Canadian stroke victims aren't getting to hospital quickly enough after symptoms set in, and then aren't getting treatment at hospital fast enough, putting them at increased risk of brain damage, according to a new Canadian study.

Based on a national review of hospital records, the Canadian Stroke Network found that less than half of Canadians who've experienced more than three hours of stroke symptoms will receive a CT or MRI scan within an hour of arriving at a hospital.

The findings, gathered from more than 38,000 patients, also found that only 23 per cent of stroke patients in Canada are treated in specialized stroke units -- a dismal number in comparison to some Western countries where admittance rates generally top 50 per cent and more.

The audit, which surveyed 295 hospitals across the country, also found:

  • Less than 1 per cent of stroke patients are benefiting from Telestroke, a 24/7 telephone service doctors in rural areas can access to quickly receive support from neurologists
  • Only 50 per cent of stroke patients were given a swallowing screen to test for dysphagia, a swallowing disorder that occurs in more than half of stroke victims
  • Only 22 per cent of hospitals provide stroke patients with secondary prevention care
  • Only 37 per cent of patients who experience moderate to severe strokes are discharged to a rehabilitation facility

This data suggests physicians and hospitals are not following the best practices that have been defined by the evidence and the literature, the medical director of Toronto Rehab's Neuro Rehabilitation Program told CTV News on Thursday.

"We believe that if they were to follow what the best practices were, we would improve outcomes for Canadians," said Dr. Mark Bayley.

The study, the first of its kind in Canada, also highlighted another problem: most Canadians are not educated when it comes to stroke symptoms.

Caused by an interruption of blood supply to the brain, strokes are the leading cause of death and adult disability in Canada. However, they are generally not considered an emergency amongst Canadians, according to a neurology professor at McGill University.

"Every minute in delay in stroke treatment result in the loss of two million brain cells," Robert Cole told The Canadian Press. But two-thirds of stroke victims in Canada wait too long before admitting themselves to a hospital.

According to the study, the optimal time frame for the best chance of a full recovery is within four-and-half hours after initial stroke symptoms have set in. Within this time frame, doctors can administer a blood clot-busting drug called tPA. But doctors must know when the stroke began because after the four-and-half-hour window, the life-saving drug can actually cause bleeding that will extend the stroke.

The five signs of a stroke, according to the Heart and Stroke Foundation of Canada, are:

  1. Weakness: Loss of strength or sudden numbness in the face, arms or legs
  2. Trouble speaking: Trouble speaking or understanding speech
  3. Vision problems: Difficulty seeing
  4. Headache: Sudden severe and unusual headache
  5. Dizziness: Loss of balance

These warning signs can be temporary and can lead to irreversible brain damage if not treated.

Comments are now closed for this story

Lorne
said
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Face started to go numb, luckily my soulmate recognized signs, and had me at local hospital stat.Staff reaction,too, was fast, and I ended up in ambulance on way to Saskatoon.Treatment @R.U.H. was excellent, and whai is more I ended up in the hands of Dr.Michael Kelly,an excellent neuro-surgeon..Thank goodness for all of people concerned,--I was extremely lucky to have them all in my life.at that time.Learn the signs, you other people, you might save someone's life with your knowledge.Ignore their denial, that is part of what happens as no-one can believe it is happening to them.


Shorty
said
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Went in to care unit with stroke symptoms - doctor told me I must have had an "allergic reaction to shellfish" - Huh?? Haven't eaten shellfish in 10 years! Stroke was confirmed by MRI at different facility, but they have never ever tested "why" I had a stroke to begine with.... was only 42.... doesn't seem to matter if the patients know the symptoms of stroke, it's the doctors that need informing.


SLY12
said
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They didn't have to do a study. I could've told them all the results they were trying to obtain.

My dad and mom had both suffered strokes over the years and needless to say, the care in hospital was less than satisfactory, never mind the ability for the ER doctor to make a proper diagnosis about a month before my mom had her stroke. She was sent home right away with two Tylenol. On the upside, once my mom was sent to Riverview, the care there was much, much better than at the general hospital where my mom was originally admitted to.


Glad to be Whole
said
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6 years ago I had a stroke at the age of 41yrs.It started with cluster headaches and numbness in my face which after a few days covered the entire right side of my face. I went to my doctor, he sent me to the neurology dept. at Foothills Hospital in Calgary. I was in the "midst" of the stroke and because of my age, they didn't feel that's what I was having. After 12 days of this, I had a massive headache/stroke. My husband called the neurology dept. and told them what had happened to me and I still waited 6 weeks for an MRI. The MRI showed the brain damage and I had slipped through the cracks of the medical system. Thank God I recovered.


E Kanniainen, Markham
said
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I'm apalled at the negative findings of the study. I was fortunate enough, at age 25, to call an ambulance right away when the symptoms of a stroke first appeared. I'm now 60 and I have no side effects whatsoever. When I tell some people about my history of stroke, they can hardly believe me.


Nancy
said
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I had an acute veterbral artery dissection stroke 3 years ago. Even though I had a sudden weakness in my legs followed not by a headache but an explosion in my head, I did not realize I was having a stroke until my husband said the words.It took 10 minutes from the first symptom to total loss of use of my right side.I received excellent stroke care from the stroke specialist at our hospital and was given the tpa in the first 3 hours after a big fight to lower my blood pressure in time so they could give it to me. Living in a small city like Brandon, MB - I was very fortunate to have a leading stroke specialist and a great rehab facility available to me.


Linda
said
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My 48 year old husband had a severe stroke 2 years ago while he was driving truck. He had a headache that morning and then his vision started to become blurry. He attempted to back his trailer into a loading dock when the people in the warehouse realized there was something wrong. When they asked him what was going on he had trouble speaking. He got out of the truck and walked into the side of the trailer as his left side started to go numb. Someone called 911 and he was taken to emergency. The doctors there were right on top of things - they did some quick tests to check for hemoraging and then told me that because the stroke had happened within a 3-4 hour period, and because of his age , and that there was no evidence of hemoraging anywhere, they wanted to admiister a drug called tpa to dislove any clots and hopefully restore blood flow to the brain. This was the only hope of restoring movement to his left side. We were extremely lucky that day - the timing was right - the hospital was not busy - the doctor's knew what they were doing - and my husband had full recovery. Most people are not aware of the signs of a stroke, how a stroke effects the brain, the different kinds of strokes, and what the treatments are - until it happpens to you or someone you know. Now we read everything on strokes and we tell everyone what we have learned about strokes in hopes that if it happens to them - they will know what to do.


peter
said
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2 years ago i had a stroke at work and recognized the sypthomsI was able to talk to my colleges and the recognized it to and called 911> within 10 minutes i was in the hospital and had a doctor looking after me. If i go with any symptoms that sometimes still come up i go to the emergency and I am the first one to belooked after. Luckily I didnt have another stroke yet but they tell me at the hospital better safe than sorry. Way to GO Brandon Manitoba. I am proud of you


Jake
said
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Last year I suffered a stroke. I recognized the symptoms immediately. I took a 350 mg of ASA and had my wife call the ambulance. I was drove to the emergency department in the hospital. A young doctor inspected me. I told him that I had a stroke and explained to him my symptoms. He insisted that I had a heart attack and not a stroke. After an EKG which showed my heart was normal, he still insisted I had a heart attacked. He ordered a blood test and told me that we would have to wait for 7 hours for a second blood test to confirm whether I had a heart attack. In the meantime, there was no treatment other than Gravol. I was helpless because I was basically immobile lying on a hospital bed. After 7 hours and a second blood test, the same doctor came and told me that I didn't have a heart attack and I actually had a stroke. After 7 hours? If I had a serious stroke, I would be dead. I was then admitted to a hospital ward and was treated for stroke. Lucky that I recovered. My own doctor told me, after examined me later, that I had a real stroke, not TSA. In fact, the hospital discharged me after one and a half day. I had to do all the physical therapeutic exercises designed by myself and now is 98% normal. I thought that I should share this with you all. Not every doctor is competent to care for you.


Anne
said
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A victim of what looks to be a stroke comes to hospital within the recommended time frame and STILL isn't treated appropriately with tPA??? What kind of crap is that? I've been in the ER, full of people with sniffles and other non life threatening conditions - this isn't rocket science here - smarten up!


Terry Sparks
said
0 0

I take 3 prescription medications that control my heart rate & blood pressure to prevent a cerebral accident. My Doctor has never discussed the signs of stroke with me nor has he ever mentioned anything about the 4 1/2 hour window of opportunity after stroke.
Our Canadian Medical system is failing us. I am left searching the internet for advice on my health concerns. This worries me; I am a 42 year old mother of 4, I can't afford to have an 'accident'.


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