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Emergency Stroke Center Opens in California County

Three hospitals will set into motion today a medical network to rapidly deploy the latest techniques to combat strokes in the Inland Empire.

Pomona Valley Hospital Medical Center will work with Arrowhead Regional Medical Center in Colton to launch the stroke system network. Loma Linda University Medical Center will join in a few weeks.

The hospitals as well as three others, which will be added in early 2012, will provide a network designed to shorten the time that appropriate care is delivered to patients, said Reza Vaezazizi, medical director for the Inland Counties Emergency Medical Agency. The agency operates and manages an emergency medical services system in San Bernardino, Inyo and Mono counties.

"Each year, approximately 795,000 people experience a new or recurrent stroke, which is the nation's third leading cause of death," said Dr. Bhupat Desai, medical director of Pomona Valley's stroke program. "On average, someone suffers a stroke every 40 seconds. Someone dies of a stroke every 3.1 minutes."

San Antonio Community Hospital in Upland, St. Mary Medical Center in Apple Valley and Redlands Community Hospital are expected to join the stroke system in early 2012, Vaezazizi said.

Although Pomona Valley is in Los Angeles County, about half of its patients come from San Bernardino County, so the hospital will participate in the new program.

The medical center already is a part of the Los Angeles County Emergency Medical Services Agency's approved stroke centers.

"Hospitals approved as participants in stroke center networks are linked together to improve response times, treatment and overall outcomes for our patients," said Deborah Keasler, director of Pomona Valley's heart and vascular center.

Emergency medical service providers will take suspected stroke victims to the nearest hospital in the system.

Part of the ICEMA's challenge in setting up the programs was to educate about 1,000 paramedics working in San Bernardino County on signs and symptoms of strokes, Vaezazizi said.

San Bernardino County joins neighboring Los Angeles and Orange counties, which began similar stroke networks in 2009.

Orange County has nine hospitals "up and down Interstate 5 and the 405," said Dr. Samuel J. Stratton, Orange County Emergency Medical Services medical director.

Los Angeles County began its network with nine hospitals, has expanded to 28 and is still looking for more, officials said.

Under these networks, telemedicine devices allow neurologists to conduct exams from remote locations by giving instructions to a patient and technician who is with the patient.

Before joining the stroke network, hospitals must establish a certified stroke center.

For that certification to happen, hospitals must operate a stroke center under stringent guidelines and performance standards. Hospitals are also required to conduct public education programs and train all employees in stroke recognition.

Once certified, a San Bernardino County hospital can apply to ICEMA for admission into the stroke network.

Widespread employee recognition of a stroke can only help speed a patient's movement through the hospital system - from the admissions clerk to the brain scan - which is key to determining what type of treatment will help the patient, said Michelle Nordman, a neuro-nurse navigator at San Antonio Community Hospital.

Officials from San Antonio and Redlands hospitals said they would like to have been part of the first group of hospitals when the county's stroke network went live today but were delayed because the certifying agency doesn't have enough inspectors to keep up with the demand generated by newly created stroke centers across the country.

San Antonio Community Hospital officials are hopeful their inspection will be in early January so it can quickly join the network, said Lynn Hill, director of cardiac services.

Inspectors will be at Redlands Community Hospital on Dec. 27, said Kathi Sankey-Robinson, the hospital's vice president for business development and marketing.

One frustration for medical authorities about strokes is that many patients with symptoms wait too long before seeking medical attention.

Prior to ARMC initiating its public education programs, stroke victims waited an average of 20 hours before seeking help. Now that time is about 6.6 hours, hospital officials said.

Although the improvement is dramatic, it's still well past the deadline for administering a drug nicknamed "clot-buster" because it can dissolve an obstruction keeping blood from reaching the brain, he said.

Advances in neuro interventions do allow specialized neurosurgeons and neuro interventional radiologists to perform some procedures 12 hours from the onset of the stroke, said Dr. Elia Haddad, director of Loma Linda's stroke center.


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