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cannot care for complications, such as bleeding of the brain, that may occur dur- ing thrombectomy." T he neu rova scu la r neu rosu rger y team performs thrombectomies in one of Crouse's two hybrid ORs — suites that allow physicians to perform minimally invasive clot retrieval and open surgery in the same room. Crouse is the only facility in the region that has two hybrid ORs, which help prevent the need to move patients from the operating room to the radiology suite for imaging during emergent stroke care. During each thrombectomy in the hybrid OR, a team of dedicated nurses and neurointerventional radiology technicians assist physicians, and the team has access to highly specialized equipment designed to examine the blood vessels of the brain and spinal cord. "Some facilities perform these proce- dures using cardiac equipment or regular radiology equipment, but the sensitivity is not nearly as good," Dr. Deshaies says. "The procedures are safer when completed using the equipment and technology we have here at Crouse." Following intervention with tPA, a minimally invasive procedure or open sur- gery, patients are transported to one of the neuro-designated beds in the ICU, where they receive care from a collaborative, specialized team of physicians, physician assistants, nurse practitioners and nurses. FROM REHABILITATION TO ONGOING SURVIVOR SUPPORT Crouse has developed relationships with some of the most advanced rehabilita- tion centers in the countr y, including Good Shepherd Rehab in A llentown, P e n n s y l v a n i a , a n d S u n n y v i e w Rehabilitation Hospital in Schenectady. These fa ci l ities suppor t t he ca re of patients of a ll ages and acuity levels — from those who need therapy to regain streng th in their legs to those who have severe cog nitive deficits or a re using a ventilator. Following discha rge, patients a lso have a n oppor tunity to ta ke pa r t in a va riet y of loca l stroke a nd a neur ysm suppor t g roups, i nclud i n g Tr iu mph Over Stroke CNY, a survivor-led support group sponsored by Crouse that meets on the first Wednesday of each month. During support group meetings, survi- vors receive education from a va riety of Crouse providers, including physi- cia n a ssista nts, nurse practitioners, psychologists and physica l therapists. " We e m p l o y a m u l t i - m o d a l i t y approach to not only the initia l therapy and recovery, but a lso long-term care," Dr. Deshaies says. "Once we get patients through stroke treatment , our focus sh i f t s t o prevent ion a nd m a n a g i n g residua l symptoms." As part of Crouse's focus on preven- tion, stroke education beg i ns i n t he hospita l for patients, their ca regivers and family members and continues on an outpatient basis at the stroke clinic where patients receive follow-up care. "Getting patients to the ED in time to receive tPA is still a struggle nationa lly a nd in Syracuse," Dr. Ra macha ndra n says. "Only 4 to 9 percent of patients who could benefit from tPA receive it, mainly because they run short on time. We educate our patients and their loved ones, and they have a basic idea of how to recog nize stroke a nd what to do if symptoms occur. Increased awareness in conjunction with rapid intervention are the keys to improving the outcomes of patients who suƒer from strokes." To learn more about Crouse's stroke s e r v i ce s , v i s it c ro u s e .o rg/s e r v i ce s/ stroke-care. ■ Advancing Progress Through Research, Education CROUSE HE A LTH IS on the leading edge of stroke treatment — as well as the forefront of research and continuing education. Clinical research trials are underway in the areas of stroke and brain aneurysm. The hospital also has a relationship with Toshiba and beta tests the company's new software and equipment as they are developed. To utilize the most up-to-date technologies, the provider teams must remain apprised of advance- ments in the field. The nurses who care for stroke patients are Stroke Certified Registered Nurses and complete eight continuing medical education credits each year. Crouse physicians regularly attend confer- ences to expand their knowledge of stroke care, and members of the physician and nursing teams have also completed the Neurocritical Care Society's Emergency Neurological Life Support (ENLS) course. In 2017, Crouse offered the ENLS course to the emergency medical services agencies with which it partners. 0 8 0 8❱❱❱❱❱ C O V E R S T O R Y