ROCHELLE — May is Stroke Awareness Month. Rochelle Community Hospital has been designated as an Acute Stroke-Ready Hospital for several years and strives to see good outcomes for area patients that suffer strokes, RCH Emergency Services Manager Janis Astle said.
Being an Acute Stroke-Ready Hospital requires that the hospital have a stroke coordinator to promote best practices and perform quality audits. It also requires having specialized education for nurses and support staff to improve recognition, care, documentation and an organized team response. Emergency department nurses do annual education on how to do specialized exams to assess patients for possible stroke.
“We use the FAST acronym for a quick assessment in triage,” Astle said. “This assessment includes a check for facial symptoms such as drooping, arm symptoms such as weakness, and speech symptoms such as slurred speech or inability to speak or inability to understand speech. The ‘T’ stands for time, meaning that time is of the essence. That's a very simple prehospital assessment that families and patients can do immediately. If the patient can't speak and notices a facial droop, for example, that's a sign of a potential stroke. The nurses’ assessment education is much more detailed. It allows nurses to more precisely give a score to a patient based on their symptoms, so we can tell how severe the stroke might be and sometimes even where it might be located.”
RCH has a dedicated process in place for stroke patients. When they come by ambulance, advance notice is received by the hospital and the patient is taken directly by EMS personnel to the CT scanner when arriving on scene to assess the brain condition of the patient. Blood is also drawn from the patient immediately after the CT is performed. Having the patient arrive by ambulance gives the patient a head start.
Strokes are generally caused by a blood clot blocking off blood flow to a certain area of the brain. There are medications and procedures that can clear that blood clot to get blood flowing again.
“Every minute that you don't have blood going to a certain area of your brain, those brain cells can die,” Astle said. “Time is of the essence because we want to open that blood vessel back up and get the blood flowing again. We can administer medication that breaks the clot up. There is also a procedure that allows a physician and support team to remove the clot. Our emergency department can administer the medications when needed. We also facilitate transfer of some patients to hospitals with a higher level of stroke care, often Saint Anthony Medical Center in Rockford.”
RCH has seen improvements in time markers related to stroke patients. In 2022 at RCH, 52 percent of stroke patients received a CT scan within 10 minutes. In 2023, that number was up to 78.9 percent. In 2022, RCH got CT scan results of stroke patients within 45 minutes 76 percent of the time. In 2023, that number was 91.1 percent. In 2022, blood test results for stroke patients were back within 45 minutes 57.1 percent of the time. In 2023, that number was 76.5 percent. Astle credits the ED physicians, nurses, and techs, along with the team response of support departments such as lab and radiology with helping RCH to achieve these impressive improvements.
Astle said those improvements tell her that patients are getting the best possible chance for as much recovery as possible.
“If patients come to us with facial drooping and arm weakness for example, the sooner they get to our ED, the sooner we can diagnose, stabilize and transfer them,” Astle said. “That is their best hope to have functional return. That might mean the difference in them being able to dress and feed themselves or to walk or speak or read to their grandkids. When you put it on an individual level, the faster we can do our part, the better chance they have of having a recovery that makes their lives as close to what it was pre-stroke as possible.”
Astle stressed the importance of residents calling 911 if they are experiencing stroke symptoms and said being transported by ambulance lends itself far better to recovery then patients driving themselves or having a family member drive them. Putting off going to a hospital when suffering from stroke symptoms can be disastrous due to the time-sensitive nature of treatment, she said. Damage from strokes can be permanent if they are not addressed as quickly as possible. She recommends that patients err on the side of caution when they are experiencing symptoms, and call 911 to get transported to RCH quickly. Even if they’re not sure the symptoms they’re having are due to a stroke, it’s better to get to the ED to get expert medical assessment and care as soon as possible.
While care for RCH stroke patients typically culminates at a larger hospital with stroke specialists, Astle said RCH has heard word of positive outcomes for many of the stroke patients it has helped over the years.
“We've seen stroke patients come in here with acute symptoms, and we find out later on that they've had a good outcome,” Astle said. “Patients will send us a thank you note or cookies. Because we're the small town and community that we are, word often gets back to us. We hear about someone getting discharged from another hospital that's doing great. We love to hear these good stories.”
Astle said that local patients that suffer from strokes having access to RCH for care is “a gift” and that their chances of a good outcome would be lower if they had to travel by vehicle or ambulance all the way to a Rockford hospital instead.
“Having a place that's right here in our own community allows the treatment to start sooner,” Astle said. “Rockford is a 35-minute drive. If RCH wasn't here, the process wouldn't even start until they get there. EMS can provide some care and starts the notification process to the next set of caregivers. The ED provides the next layer of care, and we're great at diagnosing and stabilizing patients, getting them to the specialist they need, and getting them there quickly.”
