Stroke Survivor Series: The ER

You arrive at  the ER and are rolled straight back to an open room. You hear the words "code stroke room one" on the PA system overhead. Immediately the ER nurses, technicians, and physician surround you. “Patient’s glucose is 113”, a nurse says after she pricks your finger.  A technician attaches stickers to your chest and takes blood from your arm. The ER physician asks you to do various things like move your legs and arms, and checks your eyes and facial muscles. She asks what happened and your daughter tells her about your uncoordinated movements and the difficulty speaking you’ve been having. You try to add to the story but the words won’t come out the right way. The doctor says that she’s worried you’ve had a stroke and wants to get you to the CT scanner immediately. A nurse places an IV and you are taken back to the CT scanner. The clock in the room shows 6:55 PM.

You get two CT scans, one that looks at your brain and the other with IV contrast that looks at the blood vessels in your head and neck. The IV contrast gives you a strange warm sensation. A few minutes later, you are taken back to an ER room. The ER doctor hurries into the room and sits down next to you. “I’ve just gotten off the phone with the radiologist and neurologist. The good news is that the CT scan didn’t show any evidence of bleeding. It does look like you have a big blockage in one of the major arteries in your brain. The neurologist recommends that we give you a medicine called tPA which acts like a ‘clot buster,’ then transfer you to another hospital, where the interventional neuroradiologists are trained to take the blood clot out with the help of a special catheter. This is called a thrombectomy.” She then proceeds to go through a checklist with you to see if you have any contraindications to getting the medicine. “With any medicine, there are risks and benefits,” she explains, “tPA will get rid of the blood clots that are causing your symptoms but there is a risk of bleeding in your brain or elsewhere in your body. If left untreated, the weakness and other symptoms you are experiencing could become permanent.” She goes through numbers and the percentage of people who are helped or harmed and helped with this medicine and asks if you consent to being treated with tPA.

You think about it. It’s a stressful situation and there is so much information to take in. An hour ago you were sitting with your family laughing, and now you are having to choose whether or not to take a potentially harmful drug. After deliberating and asking further questions, you agree to take the medication. As the nurse prepares the IV pump, you look at your phone and note that it’s 7:13 PM.

The nurse starts the pump and you lay waiting. The doctor comes to check on you frequently. She explains that you will be transferred to a bigger hospital downtown so that they can do the thrombectomy procedure. You hear the helicopter land outside, and shortly after a flight crew in blue overalls with a little silver helicopter on the left chest rushes in to get you to your next destination. As you roll out of the ER, the clock gleams 7:42.

Read part one and part two of the Stroke Survivor Series. See what Zeit Medical is doing for stroke survivors and those at risk for strokes here.