Stroke is the leading cause of disability in the country.
It's the fifth leading cause of death,
and it actually can happen to anyone.
Kaiser Permanente Northern California
has 21 medical centers that are all stroke centers,
and we work across medical centers to deliver care in a
systematic method for those who need a higher level of care,
who needed an intervention that isn't provided
at most medical centers.
The challenge facing everybody in this stroke community
is how do we identify people like Robert
and deliver the care in an expedited fashion?
At Kaiser Permanente, we've developed the
Stroke Express Project.
Robert benefitted from this new treatment program in that we
were able to very quickly treat him for his acute stroke.
When I first experienced something was wrong,
when my coworker came into the break room at work,
and I realized that he asked me a question;
I realized I couldn't understand what he was saying.
At that point, I tried to answer him and I couldn't speak either.
My coworker then called 9-1-1 right away.
The ambulance service showed up and I heard them radioing in
that it was a stroke.
Kaiser Richmond, Isaac speaking.
We got a pre-notification call from the ambulance,
the EMS service, that they had a 27-year-old patient, Robert.
ETA is 10 minutes. Possible stroke.
They were concerned with him having acute stroke.
They were able to give me his medical record number
and I could look at his chart.
Specifically for the stroke alert, it's an amazingly
complex system that all has to work very well,
very quickly to get the care as fast as possible.
We need to have the pre-notification.
We need to have the CT scan ready.
We immediately contacted the tele-neurologist to have
the video cart up and ready for when Robert would arrive.
I remember the look in his eyes, how scared he was.
When Robert rolled into the emergency room,
he had stroke-like symptoms.
The stroke neurologist is available via teleconsult
in a two-way monitoring fashion where the neurologist
leads the stroke code.
Can you name the objects that you see there?
And was able to perform rapid interpretation
of all the data at hand.
Once we collected all this information,
we treated him with a clot-busting drug, or tPA.
And we also notified our Redwood City colleagues who
would perform an intervention on him later in the day.
Time is everything.
We needed to save his brain by applying these concepts
rapidly and efficiently so that we'd optimize his outcome.
It was kind of surreal in the sense there was all this
going on for me.
They were such a well-oiled machine.
After I was done speaking with the teleneurologist Dr. Fox,
I alerted the rest of our team and we started to get ready
for Robert's arrival.
The techs started to get the Angio Suite ready
with all the equipment that we were going to need.
What we did for Robert is a minimally invasive procedure
where we placed a small tube or catheter in the artery
starting in the leg
and navigated up right to the blockage in the brain.
And then we deployed a device called a stent retriever,
which captures the clot and makes it possible to pull it out
and restore flow to the brain.
Patients that are having a severe stroke,
the sooner we get the artery open, the better they do.
And my right hand went up as soon as they got the last bit
out and that's when I knew that I was going to be all right.
Kaiser Permanente Stroke Express Program
has allowed us to treat twice as many patients
with the lifesaving medication tPA.
And in addition, it has allowed us to half the time of
door to needle for tPA treatment.
But yet we have been able to maintain a low
complication rate.
So if you happen to present to a Kaiser Permanente emergency room
with a stroke like Robert did, you'll have access to a
system of stroke care that includes primary stroke centers
and comprehensive stroke centers.
And irrespective to the type of stroke,
the complexity of the situation,
you'll get the best care possible.
If everything hadn't come together the way it did,
I could be paralyzed on my right side permanently,
so I'm very happy for all the doctors and the teamwork
and everything that went so smoothly for me...and so fast.
I'm back to dirt biking, jet skiing, wakeboarding,
working, all that.
It seems like it's such a trivial thing
like to thank somebody, but that's all I could offer
because it's my utmost thanks, you know.