BIDMC To Be One of First Designated Stroke Centers

BIDMC's Stroke Center Designation Committee members include (l-r) Kathleen Murray, health care quality; Jonathan Edlow, M.D., emergency medicine; Adel Malek, M.D., neurosurgery; Leland Wood, neurology; Pickett; Carvelli-Sheehan; and Schlaug. Missing from photo: Magdy Selim, M.D., Ph.D.

BIDMC has become one of the first hospitals in Massachusetts to pass the new Department of Public Health (DPH) licensing process for designation as a Primary Stroke Center, subject to finalizing a data management contract with the state.

The DPH licensing process establishes statewide standards for stroke care and designates primary stroke services in hospitals versed in use of the drug tPA, similar to standards governing trauma centers and other specialized emergency medical systems. Under new statewide regulations, ambulances with potential stroke patients will be directed as rapidly as possible to hospitals with the new stroke
services designation.

“Every 45 seconds, someone in America has a stroke, and every three minutes it results in a fatality,” says Magdy Selim, M.D., Ph.D., who co-directs the BIDMC Stroke Center with Gottfried Schlaug, M.D., Ph.D. “tPA is a leap forward in ischemic stroke treatment.” Schlaug notes, “There is a limited window of opportunity for it to be administered with success, ideally within three hours. The DPH’s effort will raise awareness and provide victims with a local outlet for this very crucial treatment.”

The goal of the new licensing process is to ensure that hospitals have established protocols and guidelines so that potential stroke victims can receive immediate treatment by medical professionals trained in stroke and experienced with administering tPA (tissue plasminogen activator), an FDA-approved, clot-busting drug. If administered within hours of the onset of symptoms, tPA may successfully counter lasting stroke effects. If treatment with tPA is not appropriate, hospitals must demonstrate that there is on-site availability or access to neurosurgery evaluation and treatment.

At BIDMC, acute stroke teams have long been assembled, consisting of neurologists with special expertise in stroke, emergency physicians, critical care physicians, neurosurgeons, radiologists, vascular surgeons and nurses. The medical center also provides the latest in diagnostic and treatment technologies, including magnetic resonance imaging, endovascular therapies and cutting-edge clinical trials.
The licensing process helps ensure that clinicians work together to provide timely and appropriate diagnosis and treatment for stroke patients. “This licensing process was a truly multidisciplinary effort involving Joan Pickett [senior director, planning and business development], the emergency department (ED), neurology and neurosurgery physicians as well as health care quality staff and ED nursing,” says Jayne Carvelli-Sheehan, vice president for ambulatory and emergency services and leader of the effort.

Ischemic strokes, which occur when blood flow to the brain is suddenly interrupted by a clot, account for approximately 88 percent of all strokes. When part of the brain dies from this impairment, the part of the body it controls is adversely affected. The impact can result in lasting and far-reaching complications such as paralysis, difficulty speaking, visual impairment and more, including death.

However, brain cells affected by a stroke can still potentially be salvaged, if tPA is administered within the first few hours of stroke occurrence. If a blocked blood vessel can be re-opened quickly enough via tPA, the stroke’s impact can potentially be minimized or, in some cases, even reversed.

BIDMC’s Stroke Center can be reached directly at (63)2-8913/ 8911.