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REF NO.: 51
SUBJECT: Preventing stroke with the right test at the right time
DATE: Dec. 19,2016
Stroke is the third-highest cause of death in Canada, and Newfoundland and Labrador has a higher rate of stroke than any other province.
Choosing Wisely NL, an initiative of Memorial University’s Faculty of Medicine, is raising awareness about the true signs of stroke so patients get the treatment they need as soon as possible.
About 20 per cent of strokes occur as a result of critical narrowing of a carotid artery, which supplies blood to the brain; hypertension and heart disease cause the majority of the remainder. Arterial narrowing can be detected in the diagnostic imaging departments of most hospitals and by a carotid artery ultrasound at the internationally accredited, non-invasive Vascular Laboratory at St. Clare’s Mercy Hospital in St. John’s. One in five strokes in the province occur secondary to warning symptoms. Meaning, patients may not respond to these symptoms or they do not get the test they need at the right time. In this situation, rapid detection of carotid disease is essential because, with urgent surgery, stroke is preventable.
Dr. Greg Browne, chief, vascular surgery, Eastern Health, says there are some early, but important, signs a patient can be mindful of before the possible onset of a stroke.
“The Heart and Stroke Foundation has a very good acronym for the signs of stroke,” he said. “It’s FAST: Face, is your face numb or weak? Arm, is one of your arms numb or weak? Speech, are you having problems speaking or is your speech slurred? Time to call 911.”
“Patients with these symptoms need urgent carotid artery testing because they may be a candidate for urgent surgery,” Dr. Browne added. “They are high risk stroke patients and they should be tested within 24 hours of having these symptoms. Even if stroke symptoms disappear, it is still important to be tested quickly for carotid artery disease because the test can identify patients who may require urgent carotid artery surgery or stenting to prevent future stroke.”
Dr. Patrick Parfrey, physician leader with Choosing Wisely NL, says that in these potentially high-risk situations, it is important for the right patient to receive the appropriate test or intervention as quickly as possible.
“Carotid artery testing is an example of a procedure where giving the right test to the right patient at the right time is very important to the health of patients,” he said. “For example, when a patient experiences symptoms consistent with carotid artery disease and it is identified within the time window where surgery will be beneficial.”
For more information about Choosing Wisely NL and the latest campaign about the prevention of recurrent stroke, please visit here.
About Choosing Wisely NL
Choosing Wisely NL is a program to help clinicians and patients engage in conversations about unnecessary tests and treatments and make smart and effective choices to ensure high quality care. It is an educational initiative seeking to more efficiently match a patient’s medical needs with the most appropriate type of care that is safest for the patient. For each initiative and outreach program, Choosing Wisely NL has identified key areas of risk and will work towards improving, through the supply of educational resources, the appropriate use of testing and treatment in these areas. The program officially launched in October 2016.
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