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Quick Stroke Treatment Can Save Your Life

By Dr. Claudia Aguilar-Chalela

In Mexico, ten patients die of a stroke every hour. As medical director of the H+ Hospital in San Miguel, I oversee both the emergency medical teams and protocols applied to stroke victims. It is my responsibility to ensure that all nurses, technicians, and physicians are properly trained and credentialed as well as board certified in emergency medical procedures. ER doctors are certified by Advanced Cardiac Life Support (ACLS).

H+’s emergency medical guidelines include a comprehensive program for full stroke recovery. The program is called “Código PILAR” (Programa Integral para la Recuperación Cerebral). It is applied to adults with signs and symptoms of sudden neurological deficit (stroke). Quick Stroke Treatment, an FDA-approved treatment for ischemic strokes, is part of H+ Hospital´s Emergency Medical Protocol.

When the Red Cross has identified that a patient has potential stroke symptoms, they apply the FAST test.

F – FACE: Smile. Does one side of the face droop?

A – ARMS: Raise both arms. Does one arm drift downward?

S – SPEECH: Repeat a simple phrase. Is the speech slurred or strange?

T – TIME: If you observe any of these signs, take action.

Red Cross EMTs are trained in ACLS and can identify when a patient tests positive for the FAST test. While in transit, they will radio the ER physician at the H+ Hospital and communicate the patient´s vital signs, medical history, and medications.

The H+ ER doctor will immediately activate the Código PILAR and alert the entire emergency medical and administrative team to prepare for patient arrival. The patient is taken directly to the emergency room; the ER doctor corroborates the patient´s diagnosis using the National Institute of Health Stroke Scale. The ER nurse applies an intravenous infusion and lab tests are taken. Meanwhile, the on-call neurosurgeon is called and arrives within 15 minutes.

The patient is rushed to the imaging room for the CT scan and then moved to the ICU.

The neurosurgeon and radiologist check the CT scan for inclusive criteria for thrombolysis (clot busting). They will also determine if the patient has had an ischemic stroke (when an artery to the brain is blocked) or hemorrhagic stroke (when a weakened blood vessel ruptures).

If it is an ischemic stroke, a tPA (tissue Plasminogen Activator) injection will be applied; tPA injections dissolve the clot and improve blood flow to the affected part of the brain. If the tPA is administered within three to four and a half hours of onset of stroke symptoms, the clot buster can significantly reduce the effects of ischemic strokes. It is applied only after confirming CT scan results.

At H+ our goal is to complete the Código PILAR sequence within a 60-minute time frame.

I invite you to contact our board certified doctors regarding emergency medical protocols. I also welcome you to attend our upcoming preventative health talks offered by Peace of Mind in San Miguel & H+ Hospital.

Dr. Claudia is the CEO of H+ Hospital San Miguel; she started her practice here 24 years ago as a bilingual & bicultural board certified doctor.


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