Calling Doc May Delay Stroke Treatment

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 ischemic stroke.

The research was presented at the ASA's International Stroke Conference 2008.

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.