Fast response for stroke

Integrated provincial strategy benefits all Albertans

Sandra McLay doesn’t remember much about the night in 2007 that she had her stroke. 

“By the time I woke up completely, it was two days later,” she says. “The nurses said I had been walking around but I don’t remember any of it.”

While she couldn’t know it at the time, McLay’s experience demonstrates the effectiveness of the Alberta Provincial Stroke Strategy (APSS). It’s aimed at preventing strokes and helping the 5,500 people who have a stroke in the province every year. 

When the paramedics arrived at McLay’s home in Sedgewick, 140 kilometres south of Edmonton, they recognized she was having a stroke and took her to St. Mary’s Hospital in Camrose, the nearest hospital that could do a CT (computed axial tomography) scan.
 
The scan was transmitted to a stroke neurologist at the University of Alberta Hospital in Edmonton. McLay was then seen by the stroke neurologist using  telehealth videoconferencing technology. The decision to give her tissue plasminogen activator (tPA), a clot-busting drug, was a collaborative decision based on the telehealth assessment, the CT image and discussion with between the emergency physician in Camrose and the stroke neurologist in Edmonton.

“A key part of stroke diagnosis is getting the CT scan to determine what kind of stroke it is,” says Agnes Joyce, acting manager of the stroke program in the Edmonton area. “TPA is only effective on strokes caused by blood clots and cannot be given if the stroke is caused by a brain bleeding.

“If you get tPA within an hour of stroke onset, you have up to a 50 per cent chance of a full recovery. The more time that goes by, the less effective the drug is because of tissue damage caused by lack of oxygen to the affected area. Even a small stroke can be devastating if it hits your speech centre, your vision or other significant areas.”

APSS works with Emergency Medical Services (EMS) throughout the province to make sure paramedics know which hospitals are equipped with CT scanners.

It has also developed integrated care plans that continue once a patient leaves hospital.

“There are a number of stroke prevention clinics, rehabilitation and community-based programs throughout the province that stroke patients can be referred to, so they are not falling between the cracks,” Joyce says.

APSS involves care providers across Alberta Health Services and is supported by Alberta Health & Wellness and the Heart and Stroke Foundation of Alberta. 

Deb Gordon, senior vice-president of Major Tertiary Hospitals for AHS, says it’s very rewarding to see the improvements in care and the strengthening of services right across the province.

“Patients no longer have to travel to major centres to get time-sensitive and outcome-improving care,” she says.