When 911 alerted Columbus Division of Fire Medic 26 in early February of a woman on the far west side presenting with stroke-like symptoms of facial droop and right side hemiparesis, Medic 26 responded. The crew quickly realized the patient was having a stroke and took the extra step to pre-notify the Ohio State Wexner Medical Center Emergency Department, which activated the stroke alert response including clearing the CT scan and allowing the stroke team to be in the ED when they arrived.
When a field activation occurs, the patient is given an emergent medical record number, and many times, we are not aware of the patient’s past medical history. In this case, Medic 26 was able to provide us the patient’s medical history, which included an excellent patient report including a LAMS score of 4 (severe), her cardiac rhythm was atrial fibrillation (significant stroke risk factor), and a picture of the list of her medications, expediting her care.
With her stroke worsening by the minute, the woman was taken directly to CT upon arrival to the Wexner Medical Center, where our Comprehensive Stroke Center team determined the NIH Stroke
Scale (NIHSS) was 9 but was rapidly increased to 17. The patient’s CT was negative for hemorrhage, and Alteplase was administered 18 minutes after her arrival. Her CT angiogram demonstrated an occlusion of the left internal carotid artery. She was quickly taken to the OR for a successful thrombectomy. Today, she is recovering on the stroke unit, and her NIHSS has improved. MRI demonstrates a small area of infarct in the left basal ganglia.
Because of the care she received from Columbus Division of Fire Medic 26 and the valuable information they provided to our staff, she received Alteplase in just 18 minutes and was in the OR with vascular access in 58 minutes. We extend our thanks to Medic 26 paramedics Brian Weiskittle and Ronald Estepp and EMT Timothy McGill for trusting us to care for their patient. You are an integral partner in helping us to ensure the best outcomes!