Calling Doc May Delay Stroke Treatment
Studies Point to Need to Call 911 at First Sign of Stroke
Feb. 20, 2008 (New Orleans) -- Dial 911 -- not your doctor -- at the first
sign of a stroke.
That's the advice of two teams of researchers who found that calling your
physician can unnecessarily delay a trip to the emergency room.
In one study, stroke victims who immediately called emergency
services arrived at the hospital hours sooner than those who contacted
their family doctor first.
A second study suggests that receptionists who answer the phone at your
doctor's office may not recognize stroke
signs, impeding a speedy trip to the hospital.
Getting to the hospital as soon as possible can mean the difference between
life and death, says Ralph Sacco, MD, an American Stroke Association (ASA)
spokesman and head of neurology at the University of Miami. He was not involved
with the research.
A speedy trip to the hospital is vital because the only approved drug for
ischemic stroke -- tissue plasminogen activator or tPA -- has to be
administered in the first three hours after symptoms arise.
The most common type of stroke, an ischemic stroke occurs when blood flow to
an area of the brain is compromised by a blood clot. This leads to the death of
brain cells and brain damage. TPA breaks up the clot, restoring blood flow to
the brain. While not a cure-all, it helps about one in three patients with
The research was presented at the ASA's International Stroke Conference
Calling Doctor Delays Hospital Arrival
In the first study, Australian researchers interviewed 198 stroke victims
who were brought to the emergency department by ambulance.
Only 32% called the ambulance immediately. About 22% called their family
doctor. The rest generally waited to see if their symptoms got worse or called
a family member or friend.
Among those who called their family doctor, 45% were screened over the phone
and advised to call an ambulance. In 36% of cases, the doctor told the patient
to come in for an exam and then called emergency services.
Once someone called for an ambulance, it took about 45 minutes to get to the
hospital, says Helen M. Dewey, MD, PhD, of the National Stroke Research
Institute and University of Melbourne.
But waiting to be seen by the doctor first delayed that call by a median of
nearly seven hours. Even if the doctor advised an ambulance be called, there
was a 1 1/2 hour delay, she tells WebMD.