Your Health Today Magazine

Level One Stroke Center Designation Means Top-Notch Care

Level 1 Stroke Center

St. Anthony’s STROKE TEAM: four neurologists, two interventional radiologists, two neurosurgeons, board-certified Emergency Department physicians, specially trained nurses

As part of St. Anthony’s Level One Stroke Center certification, an in-house stroke team is available 24 hours a day to assess patients immediately and start on treatment, said Maheen Malik, M.D., Medical Director of St. Anthony’s Stroke Program. “We have two interventionalists, B. Kirke Bieneman, M.D., and Jay Albovias, M.D., who are trained to remove clots mechanically, coil aneurysms, and work on other vascular problems of the brain,” Dr. Malik said. “Working through the groin and into the brain’s larger arteries, they use micro-catheters to remove clots. They also can inject thrombolytic drugs to dissolve clots.

“And our neurosurgical team (Fangxiang Chen, M.D., and Bassam Hadi, M.D.) is skilled at handling a hemorrhagic stroke, aneurysm or spontaneous brain bleed,” Dr. Malik said. “About 20 percent of all strokes are bleeding strokes; the others are caused by clots or plaques.”

Every four minutes in the United States, someone dies of a stroke, defined as the death of brain cells due to an obstruction of blood flow to the brain. Only heart disease, cancer and chronic lower respiratory diseases are deadlier.

When paramedics notify the Emergency Department of an incoming stroke patient, St. Anthony’s Stroke Team is activated immediately: caregivers work closely with emergency crews, and communicate by telephone and use privacy-compliant software to send photos and video prior to their arrival in the ED.

“We have a very strong support team at the hospital and a very good relationship with EMS crews; we provide education for them at the firehouses,” Dr. Malik said. “That’s important, because stroke victims who receive fast treatment are more likely to recover without permanent disabilities.”

Because the clot-busting drug tissue plasminogen activator (tPA) is administered based on weight, the ED has a special scale able to weigh patients on stretchers. EMS patients who meet certain criteria for stroke will not stop in the ED, but will be taken straight to Radiology for a CT scan, which usually is read within 24 minutes. If needed, this will be followed with advanced imaging techniques that detect salvageable brain tissue.

“From the basics to the most sophisticated interventions to treat stroke, we provide the highest level of care for stroke patients, comparable to that provided by the best medical centers in the country,” Dr. Bieneman said.

The Level One certification is the result of a state law that provides the Missouri Department of Health and Senior Services the authority to create designated stroke centers that meet standards to provide definitive and timely treatment for stroke patients. The department’s Time Critical Diagnosis System brings together the 911 emergency response system, hospitals and first responders to provide a more efficient continuum of care for trauma, stroke and heart attack victims.

“One of the things that sets our program apart is the way our nurses and our doctors work together,” said Marsha Enchelmaier, M.S.N., R.N., Manager of the Stroke Program. “We’re the southernmost hospital in St. Louis that has a Level One certification.”