Surviving AmericanSurviving
American Medicine

We are familiar with having to go to the emergency rooms and many of us have waited hours and hours for care.  Often, even with chest pain or symptoms of a stroke (numbness, confusion, headache, weakness or dizziness), a patient just has their family or friends drive them to an emergency room.

An important article was published in the Journal of the American Medical Association volume 309, page 2480, 2013 by J. Saver and colleagues from UCLA and other institutions.  They evaluated over 58,000 patients who had symptoms of a stroke, went to an emergency room, were found to have a stroke, and were then treated with tissue plasminogen activator, a clot-dissolver that improves stroke outcomes.

They evaluated the length of time from initial symptoms to the time of treatment and studied what were the outcomes.  If patients got to the emergency room faster, and received treatment more quickly, there was a 2% increase in ability to walk for every 15 minutes less time to get treatment initiated.  There was 1% to 2% increase in ability of a patient to return to an independent environment for every 15 minutes less time until treatment began.  Treatments began more rapidly if there was arrival by ambulance. Amazingly, treatments began 600% more quickly when patients arrived by ambulance than coming to the emergency room by car!

My tips are:

• If you are having symptoms of any kind, try to get to the emergency room to have symptoms resolved as soon as possible.
• Use an ambulance or paramedic to get to the hospital in case of symptoms of stroke or heart attack.
• Patients arriving by ambulance received emergency care much more rapidly than patients arriving by car.
• Never think, the symptoms are only mild, I can wait it out.

For further discussion of using hospitals efficiently, see my book “Surviving American Medicine.”