ENCSN News: 2011



2011 World Stroke Day

10/11--Pitt County Memorial Hospital (Greenville, NC) held a screening and awareness event on this year's World Stroke Day.



How did your community or agency celebrate World Stroke Day?




Prehospital Notification by Emergency Medical Services Reduces Delays in Stroke Evaluation Findings From the North Carolina Stroke Care Collaborative

7/11--Researchers from UNC-Chapel Hill analyzed data from the North Carolina Stroke Care Collaborative registry in 2008 and 2009. The researchers looked at transportation to the hospital, timing of recommended brain imaging and interpretations, as well as patient and hospital level characteristics. Of 13, 894 eligible North Carolinians in the study, 21% had brain imaging completed and 23% had interpretation of neurological exams completed within the recommended time intervals. As strong predictor of meeting the recommended time intervals was arriving to the hospital via EMS as opposed to private car. Both arriving by EMS with prenotification of suspected stroke patient and arriving by EMS without prenotification had significant association with meeting target times. However, prenotification had a much greater impact.

For the complete article, please see Patel, Rose, O'Brien, & Rosamond (2011). Stroke




Telestroke Robot at Carteret General Hospital

5/5/11--Carteret General Hospital (CGH) has partnered with Wake Forest University Baptist Medical Center’s Telestroke Network to improve its stroke care. CGH now has the use of a telestroke robot, Riley--the first of its kind in eastern North Carolina.



Riley, a remotely controlled robot with live video-audio conferencing ability, gives emergency doctors at Carteret General immediate access to Wake Forest Baptist stroke specialists at any time during the day or night.

Learn more about Carteret General’s telestroke robot at the following links, which include news videos and articles:


Increasing Stroke Capabilities: Success at Martin General Hospital

5/5/11. In the March 2011 edition of Business North Carolina Magazine, Martin General Hospital (MGH) was featured as the 10th best hospital in NC for stroke, based on stroke mortality. The top hospital listed for stroke was WakeMed in Raleigh.

To see a copy of the Business North Carolina Magazine article, click here

Since September 2010, Martin General Hospital (MGH) has been working diligently to increase its stroke capabilities, including meeting the requirements listed for a “stroke capable hospital” in the NC OEMS Stroke Triage and Destination Plan. Martin General also now has a stroke nurse coordinator, Laura Joyner, RN.

In February 2011, MGH stroke champions--Dr. Chet Johns, MD and Laura Joyner, RN--received ENCSN scholarships to travel to the University of Miami to receive ASLS instruction training directly from the creators of the stroke education curriculum. As of May 2011, they have provided ASLS training to over 100 EMS personnel representing all five squads in Martin county, and 8 additional nurses at MGH.

The progress that MGH has made in its stroke care and training serves as an example to other small hospitals in eastern NC. Consequently, ENCSN featured MGH at its October 2010 Quarterly Meeting. To see a video of MGH's stroke capabilities presentation, click here



Increasing Stroke Capabilities: Success at Albemarle Hospital

5/5/11. Albemarle Regional Hospital has been working diligently to increase its stroke capabilities, including meeting the requirements listed for a “stroke capable hospital” in the NC OEMS Stroke Triage and Destination Plan.



A "Stroke Capable Hospital" is meets the following criteria:

    • Having specific diagnostic services available, in this instance Computerized Tomography (CT) scans, with a CT technician available in-house at all times;
    • Possessing the ability to quickly and accurately evaluate a stroke patient who would benefit from thrombolytic therapy (treatment to break up blood clots in the blood vessels);
    • Having the capability, expertise and willingness to administer thrombolytics (t-PA) to eligible patients;
    • Accepting all stroke patients regardless of bed availability;
    • Providing feedback to area Emergency Medical Services (EMS).

As part of its “Stroke Capable Hospital” capability, Albemarle Health has teamed with EMS providers in its seven-county service area to initiate pre-hospital arrival stroke screenings, provide hospital notification of incoming stroke patients, and have its Emergency Department, along with Albemarle Neurology, prepared to diagnose and initially treat stroke patients. Albemarle Hospital has partnered with Sentara Healthcare, including Sentara Neurology Specialists, in Virginia, and Pitt County Memorial Hospital in Greenville, NC, to develop its processes; and has protocols in place to safely transfer patients to either Sentara Norfolk General Hospital, or Pitt County Memorial Hospital – both certified as Primary Stroke Centers by The Joint Commission.

Albemarle Hospital is proud to be a "Stroke Capable Hospital," and to be able to offer this sophisticated level of care to those patients whose quality of life may depend on timely, accurate, and effective stroke treatment,” said Sharon M. Tanner, Albemarle Health President. “In addition to being designated a ‘Stroke Capable Hospital’, we continue to focus on providing stroke education, prevention, and rehabilitation services to people throughout our region. We know that time matters in initiating treatment for the stroke patient, and we’re dedicated to decreasing the time from diagnosis to treatment, and helping stroke patients receive the care they need.”



School Nurses & Blood Pressure Guidelines: Albemarle Hospital

5/5/11. School nurses in Albemarle Hospital’s service area that have hosted stroke screenings in their schools recently received laminated copies of the JNC7 blood pressure guidelines (supplied by the East and Northeast Regions of the NC Heart Disease & Stroke Prevention Program). As part of the screening, Tanya Miller, RN, Stroke Coordinator at Albemarle Hospital, distributed copies of the JNC7 guidelines to assist with their continuing efforts to monitor and refer school staff members. The guideline cards can help staff understand their blood pressure numbers and make informed treatment decisions in consultation with their respective physicians.

Blood pressure and cholesterol guideline cards are available to ENCSN members by contacting ENCSN staff, Elynor Wilson or Christine Ransdell.



ASLS Offered & Added to Multiple EMS Curriculums

5/5/11. Congratulations to Lenoir Community College, Halifax Community College, and Currituck Fire & Rescue for making ASLS a part of their required EMS curriculums and/or offering ASLS classes.

At Lenoir Community College, stroke champion, Jeremy Hill, has ensured that ASLS is now being taught as a part of required paramedic course material. In October 2010, ENCSN was able to assist Lenoir Community College in offering an ASLS class to 11 paramedic students. Moving forward, it is expected that hundreds of paramedic students from across NC will be exposed to the ASLS course material through the Lenoir Community College paramedic curriculum.

To date, 75 technicians have received ASLS training provided by Halifax Community College. In October 2009, Halifax Community College formally adopted ASLS as part of its curriculum for newly certified EMS personnel, as well as a requirement for EMS re-certification. Each year, Halifax Community College graduates 20-30 EMS students and re-certifies approx 50 EMS personnel.

Providers from Currituck County Fire & Rescue and Albemarle Hospital completed ASLS training on March 12, 2011 in Barco, NC (Currituck County). The training was sponsored by the Northeast Region of the NC Heart Disease and Stroke Prevention Program in collaboration with Eastern AHEC. Teresa Wheeler from Currituck Fire & Rescue helped coordinate the event. Seven providers completed the training. The response from the training class was positive, leading to another training class that is being planned for this part of the Northeast Region in the Fall of 2011.



Link: See past ENCSN presentation, “Unbuckling the Stroke Belt.”
(April 2010, ENCSN Quarterly Meeting)