Adventist Health Castle | Windward Health | Winter 2019

FAST —a useful 4-letter word If you are going to receive a clot-dissolving drug or other therapy, you must get to a hospital quickly so a doctor can treat you within a few hours after symptoms begin. Adventist Health Castle’s emergency staff can administer tests to diagnose the stroke or other medical problem that caused your symptoms. If you think you or someone else is having a stroke, it’s essential to call 911. Other stroke signs Sudden numbness or weakness of a leg. Sudden confusion or trouble understanding. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, or loss of balance or coordination. Sudden severe headache with no known cause. Does one side of the face droop? Is it numb? Can you smile? Is the smile uneven? Is one arm weak or numb? Try to raise both arms. Does one arm drift downward? Can you correctly repeat a simple sentence? Is it slurred or hard to understand? Call 911 immediately, even if the signs go away. Note the time when the first signs appeared. It will help with treatment options. F ACE A RM S PEECH T IME Source: American Stroke Association O‘AHU’S NEWEST PRIMARY STROKE CENTER When every minute matters TIME IS CRUCIAL for stroke patients, who risk severe disability if not treated promptly. Adventist Health Castle’s response measures for stroke patients are in the top decile in the country. “The moment a patient with stroke or strokelike symptoms arrives at the Emergency De- partment, one of our physicians makes an immediate assessment before the patient is taken for a CT scan to determine what type of stroke has occurred,” Dianna Motley, RN, BSN, MHRM, manag- er of Castle’s Emergency Depart- ment (ED), explains. “The goal is to get patients in for a scan within the first 15 minutes of arrival, but we usually have it done within five minutes. Time means brain tissue in a stroke patient, so we count every minute.” All of the department’s nurs- ing staff are NIHSS-certified, meaning they are trained to assess patients’ symptoms—and track any changes—according to the National Institutes of Health Stroke Scale. Measurable excellence The ED’s recent certification as a Primary Stroke Center is a significant accomplishment for Castle and a testament to the high standard of care that stroke patients receive. Certification requires a thor- ough assessment by The Joint Commission, the national health care accreditation organization that examines policies, procedures and outcomes—a rigorous process that takes place over several days. “Typically, certification isn’t earned on the first try,” Motley notes. “You can imagine how proud we were to be certified af- ter one visit from The Joint Com- mission’s representative. She told us that she has never had such a good first-time survey” While Castle’s proven excel- lence in stroke care is a valuable community resource, Motley underlines the important role of patients and their families in tak- ing action at the first sign of a stroke, even if the symptoms are mild. “The biggest error is waiting to seek treatment,” she says. Lost time can mean lost brain tissue, so it’s important to call an ambulance right away so that appropriate treatment isn’t delayed. Patients often can have 100 percent resolution, even after a devastating stroke.”