When it comes to strokes, doctors say, time is brain. In other words, getting a prompt diagnosis and emergency treatment is crucial for limiting brain damage. A new study shows that crowded emergency rooms put people at risk for death or serious disability.
Crowded Emergency Rooms Mean Delayed Imaging:
In an ideal situation, a patient with symptoms such as a sudden severe headache, one-sided numbness or paralysis, trouble speaking, difficulty seeing or trouble walking should have brain imaging within 25 minutes of arriving at the emergency room. To reduce damage to the brain, experts recommend treatment with clot-busting drugs within three hours of the onset of symptoms. But not everyone should receive such treatment. It is appropriate for a stroke caused by a blood clot in the brain (ischemic stroke), but could make a stroke cause by bleeding into the brain (hemorrhagic stroke) much worse. That is why the imaging is crucial to determine what type of stroke is occurring.
How Crowding Affects Timing:
Crowded emergency rooms may not meet these goals for door-to-imaging time. Researchers reviewed medical records for nearly 500 patients treated for stroke over the course of a year. About 60 percent of the patients got brain scans within 25 minutes.
When the emergency department was crowded, however, it took longer to get patients in for imaging. The number of people waiting there accounted for a significant proportion of the slowdown for the 40 percent of stroke patients whose imaging was delayed.
What Can You Do?
Overall, this is a health system problem that won’t be easily fixed by patients. People who suspect their symptoms might be related to a stroke should act as quickly as possible to call 911 and take an ambulance to the hospital, since this usually triggers a more rapid response by emergency personnel. If there is a choice of hospital, ask the emergency medicine technicians to choose the one with the less crowded emergency department.