'Time is brain,' Mercy doctor says in stroke training program with Springfield Fire

May 11—Every minute of a stroke kills about two million brain cells, and Mercy Health — Springfield has partnered with the Springfield Fire Rescue Division to reduce the amount of time it takes to get a person life-saving treatment.

At the Fire Division's station 1, EMS personnel and Mercy Health medical practitioners shared best practices for quickly identifying a stroke, where to take a patient for the best care and helpful information to share with the receiving hospital. These trainings took place Tuesday and Wednesday, and another will take place today.

Felix Shanahan, EMS officer, said these trainings are the first step in improving stroke outcomes in the area. The next is to educate the community on the signs of a stroke and what to do if they or someone around them is experiencing symptoms.

"We have to make sure that the layperson in the community would be able to recognize what some of those symptoms would be so that they would seek care immediately, and hopefully that care would include calling 911 because we can facilitate that care happening quicker," Shanahan said.

Stroke is the second leading cause of death in Clark County and the third in Champaign County, said Dr. Jody Short, an interventional neurologist at Mercy Health — Springfield.

The most common type of stroke is ischemic, where a clot blocks blood flow to the brain, Short said. Other strokes are typically hemorrhagic, in which a blood vessel ruptures and bleeds in the brain, which can be toxic.

Age and pre-existing medical conditions like hypertension and heart abnormalities increase the risk of stroke, Short said. A stroke can occur at any age and may present differently in different people and depending on where in the brain it is happening and the type of stroke.

"Your younger person who presents with stroke may have more headache because it may be from a (carotid) dissection," Short said. "Older people, usually the traditional thing we think of, they smoke, they have diabetes and high blood pressure — they may have atrial fibrillation, those kinds of strokes."

According to the American Stroke Association, a stroke can cause symptoms including one-sided paralysis, speech or language problems, vision impairment, changes in behavior and memory loss. An untreated stroke can result in more long-term disabilities or death.

To reduce these risks, the Fire Division uses a stroke pre-screening tool known as the Cincinnati Stroke Scale to evaluate the symptoms a person is experiencing and determine the likelihood of a stroke. In partnership with Mercy Health, the division will now adopt the BEFAST (Balance, Eyes, Face, Arms, Speech, Time) test to use in conjunction with the Cincinnati Stroke Scale.

"Time is brain," Short said, referring to the fact that the more time that elapses during a stroke, the more brain tissue a person will lose.

Shanahan said patients who EMS is transporting or whoever has their power of attorney can decide to which hospital they will be transported, but EMS will suggest a different facility if the one they want does not have the ability to do a thrombectomy, where doctors surgically remove a blood clot from a blood vessel.

"Figuring out how to communicate that medical advice without seeming like we ... had some kind of bias or something of that nature — we have to go kind of easy there; we have to honor people's wishes," Shanahan said. "So if were to, say, want to go to a facility that was not able to do some of the treatment the Springfield Regional was, how do we say, 'We think you maybe should reconsider.'"

Mercy Health is continuing this partnership, and will add other partners at an EMS educational symposium teaching on various topics, include acute stroke treatment options, on June 9.

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