Time is a special and meaningful thing, and a very complex beast: Sometimes it goes by slowly, other times it seems like we lose complete track of it. But in emergencies time is always a major factor in the safety and health of those involved.
Frontenac Paramedic Services has partnered with the Heart and Stroke foundation to install ‘FAST decals’ on all of their ambulances in an effort to improve awareness of the importance of early recognition and reaction to a stroke.
FAST stands for:
Face – Is it drooping?
Arms – Can you raise both?
Speech – Is it slurred or jumbled?
Time – to call 911 right away!
Time is especially critical when someone is experiencing symptoms of a stroke.
“There is a time critical period that exists when a person experiences a stroke, from the time that they recognize the symptoms, to the amount of time it takes emergency services to arrive and transport them to hospital. The longer the condition is left untreated the more damaging the results can be,” said Cory Watkins, manager of community fundraising with the Heart and Stroke Foundation of Kingston and Area.
There are different types of strokes, however most of the strokes that emergency services see are those that are caused by blood clots that form in the brain. There are effective treatments for this type of stroke, but they are dependent on time.
“There are treatments that aid in breaking up the clot that is causing the stroke, and then there are more technologically advanced treatments that are provided at some, but not all hospitals,” Watkins said of the type of treatment and protocol used within the Kingston area.
In 2017, Kingston Health Sciences Center (KHSC) announced the 24/7 availability of a new treatment called Endovascular Thrombectomy (EVT). KHSC says that upon arrival to the facility, the clock starts ticking and the first step is to get the patient into CT (computed tomography) scan in less than 10 minutes. Patients may quickly be given a drug normally referred to as tPA (tissue plasminogen activator) to break up the clot, however the drug has a window of effectivity and can only be administered within four hours of the beginning of a stroke.
The newer treatment offered at KHSC involves the removal of the clot by threading a stent-like device connected to a wire through an artery and up to the brain. It then meshes with the clot and, once removed, should clear the blockage and restore normal healthy blood flow to the brain.
“Many hospitals surrounding Kingston are not trained or able to treat patients suffering from a stroke,” said Marc Goudie, deputy chief of performance standards for Frontenac Paramedics.
“Usually, when our paramedics confirm the symptoms and conclude that a stroke is the most likely cause, they will initiate what we refer to as Stroke Protocol. This means that the ambulance will bypass the hospitals that are unable to provide the needed treatment and transport directly to Kingston General Hospital.”
According to Goudie, paramedics are not trained or authorized to provide any significant medication or treatment to stop the progression of a stroke.
“This is where the factor of time comes into play. By creating protocol directly for stroke patients, we then have a solid base for time sensitive transport,” he said.
In 2017, Frontenac Paramedics responded to 229 stroke related calls. Of those, 124 were women and 105 were male. Only 9 of the stroke calls in 2017 involved patients under the age of 50, while the remaining 220 were over the age of 50. So far in 2018, from Monday, Jan. 1 to Wednesday, Oct 31, Frontenac Paramedics have responded to 182 stroke calls. Stroke is the leading cause of adult long-term disability in Ontario, and the third-leading cause of death. Approximately 13,000 Canadians die of a stroke each year, and 405,000 live with the continued effects of a stroke.
“We want to make sure that everyone knows the signs and symptoms of a stroke and what to do if they witness or experience one. The major thing is to call 911 as soon as you think you or someone else may be having a stroke,” explained Goudie.
Ontario Mission Director of the Heart and Stroke Foundation Karen Trainoff said that she is delighted to expand the reach of the FAST campaign through this very meaningful partnership with Frontenac Paramedics.
“We know that public awareness increases in communities that have FAST decals on their vehicles. We are thrilled to know that people will be reminded of the FAST signs of stroke every time they see a Frontenac Paramedic Services Ambulance,” she said.
“Our main objective is to ensure that all Canadians, no matter where they live or how old they are, know and remember the FAST sings of a stroke.”
The decals, which started being installed in July, have been installed on many ambulances in the fleet. According to Deputy Chief Goudie, as new ambulances arrive, or others are sent for maintenance, the decals are applied, and eventually the entire ambulance fleet will display the awareness decals.