Solving the Issue of Patient Arrival Time

Abstract

See related article, pages 2376-2378. Late arrival to the hospital after the onset of acute stroke symptoms is a plague of unheralded proportions that is not easily treated or cured. Contributors to this problem are many, including a lack of urgent response to symptoms on the part of patients and family, patient inability to activate emergency systems attributable to neurologic deficits, and even fear of embarrassment on the part of lay people that they may have made an inappropriate call to 911.1–9 Although clinicians and the lay community have come together to successfully tackle late response to symptoms of myocardial ischemia, no doubt the presence of chest pain and shortness of breath in and of themselves have contributed to a heightened sense of urgency in response to acute coronary symptoms. At more than 10 years from the approval of tissue plasminogen activator for intravenous thrombolysis in ischemic stroke,10 it is discouraging at best to note that public awareness coupled with an urgent community response to stroke symptoms has yet to be realized for victims of this relatively “painless” yet devastating disease. The study by Jarrell and colleagues11 evaluated “healthline” phone service responses to a stroke victim …