A Stroke of Success

Stroke is the number one cause of disability in the nation and the fourth leading cause of death. However, White River Medical Center (WRMC) and the University of Arkansas for Medical Sciences (UAMS) work together every day to prevent patients experiencing a stroke, like Batesville native Charles "Buck" Buchanan, from becoming a statistic.

When Charles turned to his wife one morning during breakfast and spoke with garbled speech, she was baffled. "He just wasn't making any sense. I thought he was teasing me," said Maxine Buchanan, wife of 54 years. When he sat down to eat and repeated the same strange sentence, she instantly knew what was wrong.

Charles was having a stroke.

She drove Charles, 78, to the WRMC Emergency Department where nurses quickly swarmed around him. After a Computed Tomography (CT) scan of his brain and an in-depth assessment, it was confirmed—a stroke was trying to claim another victim.

"I had a hard time believing this was happening," said Charles. "I couldn't identify pictures. I couldn't say sentences. I couldn't even say January or February."

Nurses quickly prepared him to be seen by a neurologist through the Arkansas SAVES (Stroke Assistance through Virtual Emergency Support) Telemedicine Program delivered by UAMS, a live two-way video communication that links stroke patients and their local hospital physician to an on-call neurologist in Little Rock.

Stroke patients have the best chance of recovery if treated quickly. The AR SAVES program treats patients within 4.5 hours of their last known well time. The telecommunication allows the consulting neurologist to witness the nursing assessment through interactive video. The neurologist can speak to the patient and the care team for additional information. Digital CT images are transmitted to the neurologist providing vital information for accurate diagnosis. By significantly decreasing the time between the beginning of symptoms and treatment, the risk of permanent disability or death is also decreased.

After being assessed by a neurologist through video, doctors determined Charles' stroke was an ischemic stroke, a stroke that occurs due to blocked blood vessels in the brain. He was administered a blood clot dissolving drug called tissue plasminogen activator (t-PA). "Two hours after being given the drug, he was speaking where I could understand him. Not perfectly, but he was improving," said Maxine.

Just two days after his stroke, Charles had his life back. "It was absolutely amazing to both of us how quickly he (Charles) was well," said Maxine. "We truly believe the technology helped save him."

Since joining the program in 2008, eighty WRMC stroke patients have been treated using the Arkansas SAVES program. Fourteen have received the t-pa drug. WRMC was the 7th Arkansas hospital to participate in the program. There are now 36 sites.

A number of factors increase the risk of having a stroke including family history, high blood pressure, high cholesterol, heart disease, obesity, diabetes, and alcohol or drug use. Stroke symptoms can be remembered by using the acronym FAST. Face: drooping on one side of the face; Arm: drifting down of the arms; Speech: slurred or garbled speech; Time: Call 911 immediately if any of these signs are noticed.

WRMC is a 199-bed regional referral center and the flagship facility of White River Health System (WRHS). WRHS is a not-for-profit healthcare system serving residents throughout North Central Arkansas. The system includes hospitals, outpatient facilities, rural health clinics, and primary care and specialty physician offices. White River Health System is a member of the Premier Alliance, the American Hospital Association and the Arkansas Hospital Association, is a recipient of the Governor's Award, and is licensed by the Arkansas Department of Health.