State

Modesto Hospital named stroke center

Doctors Medical Center of Modesto has been designated as a primary stroke center, signaling a concerted effort by the hospital to improve emergency treatment and monitoring for people who have suffered a stroke.

The Joint Commission, an organization that accredits hospitals, approved the certification after a review at the Florida Avenue hospital in April. Before it received the designation, the nearest stroke centers were in Fresno, the Bay Area and Sacramento.

Stroke centers are part of a national initiative launched in 2003 to execute protocols and guidelines known to save lives or prevent long-term disabilities from stroke, the third leading cause of death in the United States. There are more than 600 stroke centers at hospitals in 49 states.

Each year about 750,000 people suffer a stroke, an attack caused by a blocked or ruptured blood vessel in the brain. It often results in impaired brain function, paralysis, speech and vision problems, memory loss or death.

Stroke symptoms can be fairly subtle, however, and sometimes patients do not seek emergency treatment.

"The public understands that heart attacks are a medical emergency and we provide excellent care for those patients," said Dr. Robert Barandica, medical director of Doctors' emergency department. "We want the general public to see stroke as an emergency as well. And we want to provide the same level of care for stroke patients."

Stroke centers follow the guidelines of the American Stroke Association and the Brain Attack Coalition of Maryland, a group of professional, voluntary and government entities trying to reduce stroke-related disabilities.

The Modesto hospital formed stroke teams made up of neurologists, radiologists, emergency room staff, lab personnel and critical care nurses. It trained staff in diagnosing and treating stroke, worked to improve coordination with emergency services and maintains a unit where stroke victims receive special monitoring and care.

Earlier this year, the hospital started calling alerts when a patient in the facility suffers a stroke or stroke victims are en route to the ER. As the stroke team is activated, a phlebotomist responds to draw blood for testing and radiology equipment is freed up for the patient.

For strokes caused by a blood clot, a drug can be given within three hours of the onset of symptoms to dissolve the clot. But doctors need to see images of the brain to tell if a clot or broken blood vessel caused the stroke.

To meet the stroke center requirements, the medical center also has 24-hour lab services, brain imaging equipment and the ability to perform surgery for stroke patients within two hours, said Cheryl Harless, clinical director of neuroscience services at Doctors.

Emergency services officials are discussing whether ambulances will bypass other hospitals to take stroke patients to Doctors. In medical emergencies, paramedics often take patients to the nearest hospital.

"We are discussing with our medical director whether there will be a change in destination for those patients," said Steve Andriese, executive director of the Mountain-Valley Emergency Medical Services Agency, which regulates ambulance service in Stanislaus and four other counties.

"It certainly is an advancement for our area and we always like to see that," he said. "There has been some debate about the effectiveness of transporting patients long distances to stroke centers. Those things have to be worked out before we finalize any policies."

Andriese said there was talk several months ago that Modesto's Memorial Medical Center also would seek the stroke center certification, but the hospital is not applying to the Joint Commission, a spokeswoman said this week.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.

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