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New transport protocols improving outcomes for Okanagan stroke patients

April 25 was a night that, for Dr. Michelle Linekin, is a big blur.

“I don’t remember much of anything,” Linekin told Global News.  “I filled in the gaps from what people told me afterwards.”

The Penticton, B.C., family doctor had just come home from a work meeting on April 25 and grabbed some chocolate as a late-night snack.

As she sat eating it, the chocolate started dripping out of her mouth.

“I had no idea, I tried to get up. I couldn’t get up,” Linekin said.

Fortunately her husband was there.

“I went up close and said, ‘Something is odd here, please say something — answer me,’ and she wouldn’t,” said Linekin’s husband, Phillip Mansfield. “That’s when I knew something was terribly wrong.”

Mansfield said that’s when he called for help.

“I immediately called our neighbour, who is a paramedic and right after that I called 9-1-1,” he said.

Mansfield said the neighbour immediately recognized that Linekin had a stroke and by the time the ambulance had arrived, the decision was already made to bypass the Penticton hospital and instead head straight to Kelowna, the epicentre for stroke care in the region, for endovascular therapy.

The bypass transport protocols have only been in place for a few months and essentially allow paramedics to make a determination that the patient is suffering from a major stroke and requires immediate care in Kelowna.

“The problem is that even if you’re really good at your care, say for an emergency room, they’re very, very good, but you still lose a lot of time by just stopping at that hospital and then coming here,” said Dr. Aleksander Tkach, medical director for the Interior Health Stroke Network, who is credited with getting the new transport protocols up and running.

“So a lot of places have implemented these bypass systems where if you have a stroke, the EMS (Emergency Medical Services)  shows up, they say, oh, that’s a really bad stroke…probably definitely needs to get to Kelowna.”

Tkach said with the brain losing about two million brain cells each minute in a major stroke, the new bypass protocol buys critical time for the patients and drastically improves their outcomes.

“Stroke is this thing where it often doesn’t kill the person but does leave them disabled long term,” Tkach said.

Putting the new transport protocols in place was heavily reliant on paramedics and getting them trained to recognize and provide pre-hospital stroke care including administering a new drug that protects the brain while en route to hospital.

“The impact it had in our community with pre-hospital care was dramatic,” Tkach said. “I’ve worked in a lot of big cities. These people are better than a lot, they’re better than anybody else I’ve worked with, that’s for sure.

“Phoenix, Seattle, Denver, whatever, they are phenomenal at their job and so when we came to them with, ‘Hey, we can do more for stroke. Will you help us?’ that buy-in was immediate.”

For patients such as  Linekin, the new stroke response has been life-altering.

“I really don’t think she’ll have any long-term deficits,” Tkach said. “And based on the kind and what the size of the clot was, how bad it was, kind of how bad the lack of blood flow was, I think that even even 15-20 minutes probably would have been too late.”

And while she’s still not able to do things like work or drive, Linekin is grateful for enhanced stroke care in the valley that has given her a second chance at life.

“I think it’s very strange actually to have a stroke that I think should have killed me and I can come back to doing things,” Linekin said.

“Certainly, I think the alternative would be dying so I think it’s pretty good.”

Source: Global News