Ever heard of a brain transplant? Why strokes are different from most other serious medical issues
HARRISBURG, Pa. (WHTM) — With other kinds of medical issues — even serious ones — Josh Erdman and Lacey McGuire, a paramedic and advanced EMT with LifeTeam, aren’t focused only on getting a patient to a hospital as quickly as possible.
“A lot of things we can handle on scene on our own and administer treatments — and make the patient better before we get them over to the hospital,” Erdman said.
But not — for the most part — with strokes.
“A big thing we’re taught in EMT and paramedic school is that ‘time is brain,'” Erdman said. “Every second that you spend without having blood being perfused to your brain, your brain cells start dying.”
By the millions, explained Dr. Steve Zanders, the medical director of stroke care for UPMC’s central Pennsylvania region said. And only hospitals — and not even all hospitals — can do procedures like thrombectomies, which remove blood clots and prevent permanent damage.
Another key difference between strokes and other serious ailments?
“We have organ transplants for liver, kidney, heart, lung,” Zanders said. “But the brain cannot be replaced. So time is of essence to save the neurons that are the essential working factors of the brain.”
Thrombectomies, which previously existed to unclog arteries in ailing hearts, have only been around to treat strokes a little more than a decade, he said.
“So it’s a brain attack,” Zanders explained. “We’re doing the same kind of procedure. We go into the artery and relieve it of its obstruction, much like you would do in the arteries of the heart.”
Zanders said the prognoses for stroke patients is now completely different from when he started practicing medicine about 30 years ago.
“Now seeing patients being able to walk and talk, when they previously wouldn’t have had that ability — that’s transformative for us,” said Zanders, who showed how a catheter goes all the way from an artery in a patient’s leg to their brain to remove the clot.
Even newer than the thrombectomies is the artificial intelligence (AI) — in place at UPMC Harrisburg for about two-and-a-half years, Zanders said — which does things like send scans of a patient’s brain to Zanders’s cell phone and even his smartwatch before the patient is even out of a CT scanner, which they’re often in less than 10 minutes after they arrive at the hospital.
The same AI helps coordinate logistics like launching the hospital system’s helicopter when a patient is diagnosed at another UPMC hospital.
“And even though we make the diagnosis, we could say, ‘You know what? You’re closer to Maryland, based on where you are. Let’s get you there” (i.e., to a hospital in a different system), Zanders said. “That’s what we care about.”
All the stroke-treatment speed within the hospital world, though, is only as good as how quickly someone suffering a stroke gets help.
“Someone will say oh, it’s been several hours or possibly even days since things have started,” Erdman said. “And in the back of our minds, we’re like, ‘Oh, I wish they would have recognized this sooner.”
The good news, though, Zanders said, is most people nowadays are getting timely care. He said the key to recognizing stroke systems is to remember this acronym: BE FAST. It stands for:
Balance: loss of coordination or balance
Eyes: sudden double-vision or vision loss
Face drooping on one side
Arms: one becomes weak or numb
Speech: slurred speech
Time: of the essence; call 911 immediately.
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