Issue link: https://viewer.e-digitaledition.com/i/918942
CROUSE HE ALTH'S NATIONALLY RECOGNIZED TE AM OF NEUROLOGISTS AND NEUROVA SCUL AR NEUROSURGEONS, LE ADINGŸEDGE TECHNOLOGY, AND FULL SPECTRUM OF MEDICAL, INTERVENTIONAL AND SURGICAL TRE ATMENTS FOR ISCHEMIC AND HEMORRHAGIC STROKE POSITION THE HOSPITAL'S STROKE CARE AMONG THE MOST ADVANCED IN THE REGION. I N 2 0 17, C R O U S E — one of on ly t wo New York St at e Department of Health-designated Stroke Centers in Onondaga County — celebrated a milestone. For the seventh straight year, the hospital received the American Heart Association's Get With The Guidelines – Stroke Gold Plus Quality Award. This recognition is given to hospitals that consistently comply with evidence-based standards and quality measures, and speaks to the commitment the Crouse team has made to providing the highest level of stroke care. The mantra "time is brain" remains top of mind for Crouse's clinical experts and guides stroke care decision-making. To ensure patients are treated as quickly as possible, Crouse has implemented multiple protocols that reduce the time it takes to move patients through the Emergency Department (ED), complete diagnostic imaging and initiate interventions. THE CARE TIMELINE En route to the hospital, emergency medical services personnel alert the Crouse ED team that a patient presenting with stroke symptoms is on the way. A team that includes emergency medicine physicians and nurses, who have completed specialized training in caring for stroke patients, then quickly assembles in anticipation of the patient's arrival. As soon as the ambulance arrives, physicians quickly evaluate patients and transport them to the CT bay adjacent to the ED. An attending neurologist is on call at Crouse 24 hours a day to respond to stroke emergencies. The attending neurologist exam- ines patients and reads each CT scan to confirm if patients are experiencing a stroke and, if so, determine the course of treatment. Neurovascular neurosurgeons from Crouse Neuroscience Institute assume the care of patients presenting with a hemor- rhagic stroke resulting from an intracerebral or subarachnoid hemorrhage. Depending on the case, patients experiencing a hemorrhagic stroke may go directly to the operating room for surgery or to one of the designated neuro ICU beds within Crouse's ICU. The vast majority of stroke patients — more than 80 percent — experience an acute ischemic stroke. These patients may be candidates for intravenous tis- sue plasminogen activator (IV tPA), which is administered in the CT bay. "If patients arrive at the ED within three hours of symptom onset, we can administer the clot-buster tPA," says Tarakad Ramachandran, MD, FRCP, Stroke Director and Professor Emeritus at Crouse. "On a case-by-case basis, we may also administer tPA beyond the three-hour window, specifically if patients are younger than 82, do not have diabetes and are not taking Coumadin." Crouse's door-to-needle times for tPA administration are among the fastest in the region. For the past three years, the hospital achieved Target: Stroke Honor Roll – Elite Plus status. According to American Heart Association guidelines, facilities that receive this recognition initiate IV tPA within 60 min- utes in 75 percent or more cases of acute ischemic stroke and within 45 minutes in at least 50 percent of cases. The team at Differentiate Stroke Care at Crouse Health A World-class Team and Innovative Technology One of two hybrid OR suites at Crouse used for complex, intricate stroke rescue procedures of the brain. BY TIFFANY PARNELL Tarakad Ramachandran, MD, FRCP, Stroke Director and Professor Emeritus at Crouse Tarakad Ramachandran, MD, 0 6 0 6❱❱❱❱❱ C O V E R S T O R Y