The statistics are sobering.
On average, a stroke happens every 40 seconds and every four minutes someone dies from a stroke.
The data is likely worse in South Carolina. Historically, the state has had one of the highest stroke-incident rates because of lifestyle choices such as smoking, eating fatty foods and not exercising.
Heredity is a factor too, especially among blacks, who are 60 percent more likely to have a stroke than whites in South Carolina.
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Time is of the essence when treating a stroke.
Critical care is measured in hours - from the time of stroke, not when someone finds a possible stroke victim. Four hours and 30 minutes usually is the maximum time window to administer clot-busting drugs to someone having a stroke caused by a blocked blood vessel.
For years, ambulances would drive up Interstate 77, bypassing Piedmont Medical Center in Rock Hill for Carolinas Medical Center's main hospital in Charlotte. Dr. Mark Porter, a neurologist with Metrolina Neurological Associates in Rock Hill, said the decision was "appropriate," as Piedmont's use of the clot-busting drug TPA - short for tissue plasminogen activator - was sporadic.
This morning, Porter and others will stand proudly as the Joint Commission's accreditation of Piedmont Medical Center as a stroke center is officially announced. The medical center decided a year ago to seek the accreditation from the commission, which is recognized as the industry's standard setter. Porter is the stroke center's medical director. Tina Cronin, a registered nurse, is the director of the Neurosciences and Stroke Program.
It is a big step forward for Piedmont Medical Center and a bigger step forward for York County residents in access to medical care close to home.
It took a team effort to become a stroke center, an effort which focused on education, efficient use of time and technology.
A goal is to administer TPA within one hour of arriving at the emergency department if the patient meets the medical standards for the drug - 60 minutes is the newly released standard set by the American Heart Association and the American Stroke Association.
The quicker TPA is properly administered the more it can reduce the severity of a stroke.
Education started with the front line personnel, the emergency medical technicians. Porter said they have embraced the training. Calls that they are transporting a potential stroke victim set in motion Piedmont's stroke team.
The stroke team of doctors and nurses in the emergency department evaluates potential stroke victims. A CT scan and blood work is done. Time for those tests is crucial, Porter said. Efficiencies in such tests affect not only stroke patients but everyone in the emergency department, Porter said.
Consulting with a neurologist is often needed. Porter's private practice is within a quick walk from the emergency room. But racing to the emergency room can disrupt his patients. To give emergency personnel options, Piedmont is using the Medical University of South Carolina's "telestroke" or REACH service.
The Remote Evaluation of Acute Ischemic Stroke or simply, REACH, is a web-based, tele-medicine system through which stroke consultations are delivered to physicians and nurses caring for acute stroke patients in rural/community emergency departments near a stroke specialty center, such as the Medical University of South Carolina.
Piedmont and Springs Memorial Hospital in Lancaster use the REACH service.
Follow-up care for those who received TPA - as well as those who do not - is critical too. Doctors such as Porter determine why the stroke happened, what kinds of therapy are needed, and if drugs are an appropriate treatment. Lifestyle changes usually are part of the treatment too.
The accreditation, Porter said, should increase consumer confidence in Piedmont.
It might help change another sobering statistic.
Nationally, only 4 percent to 5 percent of stroke victims receive TPA within the necessary time window, Porter said. After that, TPA is no longer effective and it can increase the risk of bleeding inside the brain.
"People don't come in soon enough," Porter said.