Stroke care

The Joint Commission, an independent national health care accrediting agency, awards Advanced Certification for Comprehensive Stroke Centers to those hospitals that have specific abilities to receive and treat the most complex stroke cases. This certification recognizes the significant differences in UCHealth’s resources, staff and training to save lives and preserve function. University of Colorado Hospital recently earned its 3rd recertification for Comprehensive Stroke.

Outcomes

Memorial Hospital Central has received certification from DNV GL – Healthcare as a Comprehensive Stroke Center, reflecting the highest level of competence for treatment of serious stroke events. The DNV GL – Healthcare Comprehensive Stroke Center Certification is based on standards set forth by the Brain Attack Coalition and the American Stroke Association, and affirms that the medical center addresses the full spectrum of stroke care – diagnosis, treatment, rehabilitation and education – and establishes clear metrics to evaluate outcomes.

Medical Center of the Rockies and Poudre Valley Hospital are proud to have earned The Joint Commission’s Certificate of Distinction for Primary Stroke Centers, which recognizes centers that make exceptional efforts to foster better outcomes for stroke care.

The stroke recovery process begins right away in the hospital—and continues at a designated rehabilitation facility or on an outpatient basis. The sooner you start rehab, the better your chances for a full recovery.

Our stroke rehabilitation team helps you recover as much function as possible while you retrain your body and adapt to any changes you experience. You may receive care from any of our specialists, including:

• Physiatrist (doctor trained in physical medicine) – Leads your team of specialists in providing rehabilitation care
• Physical therapists – Help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities
• Occupational therapists – Help improve your ability to perform typical tasks in daily living and working environments
• Speech therapists – Assess, diagnose, treat, and help prevent speech, language, thinking, communication, voice, swallowing, fluency, and related disorders
• Dietitians and nutritionists – Plan food and nutrition programs and supervise meal preparation and serving; treat and prevent illnesses by promoting healthy eating habits and recommending dietary modifications, such as using less salt for those with high blood pressure or reducing fat and sugar intake for those who are overweight
• Social workers – Provide support during rehab for you and your family; coordinate after-care services and offer psychosocial support
• Discharge planners – Work with you and your family to help you return home or find the most appropriate setting for your ongoing care

As you arrive at the hospital and begin the process of stroke diagnosis and treatment, you may receive care from many members of our Stroke Team, including:

• Emergency physicians and nurses – Continue stabilization and diagnostic work-up
• Stroke nurse practitioner – Directs your care, including treatment decisions
• Neurosurgeon – Specializes in surgery of nervous system structures, including stroke-related procedures to treat hemorrhages and aneurysms
• Neurologist – Diagnoses and treats medical (non-surgical) disorders of the nervous system
• Hospitalist (hospital-based medical doctor) – Specializes in caring for patients admitted to the hospital
• Interventional radiologist – Specializes in using advanced imaging (CT, fluoroscopy, ultrasound) to perform procedures; stroke-related goal is to quickly clear blocked blood vessels
• CT/MRI staff – Take radiographic images to identify the source of neurologic issues
• Neuroradiologists – Use x-rays, CT and MRI images to diagnose disorders and diseases of the nervous system
• Intensivist – Specializes in helping patients who require critical care for diagnosis
• Neurological ICU and neuroscience unit nurses – Provide continuing care after you’re admitted, guide efforts to prevent complications, and help prepare you for stroke recovery and rehabilitation; our Neuro ICU is the only one in the state and one of the oldest in the nation; most of our Neuro ICU nurses hold designations as Critical Care Registered Nurses (CCRN) or Certified Neuroscience Nurses (CNRN); our Neuro ICU received the 2012 gold-level Beacon Award for Excellence from the American Association of Critical Care Nurses (AACN), one of only two neuro ICU units in the country to achieve this recognition
• Social workers – Work with you and your family to offer support during hospitalization for what is often a life-changing event; coordinate after-care services and provide psychosocial support to your family
• Discharge planners – Help you and your family prepare you for discharge to the most appropriate setting, whether that’s inpatient rehabilitation, another rehabilitation hospital close to your home, a skilled nursing facility, or outpatient therapy services

Learn about upcoming educational stroke classes and events

Stroke prevention is still the best medicine. The most correctable conditions linked to stroke are:

• High blood pressure – Treat it.
• Cigarette smoking – Quit.
• Heart disease – Manage it.
• Diabetes – Control it.
• Transient ischemic attacks (TIAs) where stroke symptoms appear for a short time and disappear – Get help.

Learn about TIA (transient ischemic attack)

Blood tests can’t yet tell us if you’re having a stroke. We must rely on brain images taken with either MRI or CT advanced technology. Our physicians also use CT perfusion and CT angiography to look for blocked blood vessels in the brain or areas that aren’t getting enough blood.

We take these scans almost immediately when you get to the hospital, so we have time to evaluate your specific situation and make decisions about your treatment options.

Stroke treatments currently include:

• Drugs, such as tPA, that “dissolve” the clot in an artery; tPA, the drug most commonly used to break up blood clots in the brain, can be delivered intravenously (IV) up to 3 hours after you experience the first signs of stroke; in the UCHealth system, we typically beat the national standard by more than 15 minutes for tPA delivered by IV
• Intra-arterial (IA) treatments – Depending on the location and severity of your stroke, you may need an intra-arterial procedure once you’re at the hospital; in the UCHealth system, you have access to our specially trained interventional neuroradiologists who meet or exceed the national guidelines and have successfully used IA methods to:
  • Deliver clot-dissolving tPA up to 24 hours after stroke symptoms first appear
  • Capture and remove blood clots inside blood vessels of the brain (mechanical embolectomy) with the Merci® ‘corkscrew’ retrieval device up to eight hours after first symptoms
  • Remove a blood clot in the brain using the Penumbra® suction catheter

Cerebrovascular disease treatments include:

• Anticoagulant and antiplatelet medications to help prevent blood clots
• Surgical/interventional procedures
  • Carotid endarterectomy to remove plaque in narrowed or blocked arteries of the neck; we’ve achieved a 100 percent survival rate while treating nearly 50 patients during the past four years, which beats the national standard
  • External/internal carotid artery bypass to get around the clogged artery and resupply blood to the brain
  • Clipping or coiling to stop blood flow in a brain aneurysm or hemorrhage; we’ve achieved a 100 percent survival rate while treating more than 250 patients during the past four years, which exceeds the national standard

When you arrive at the hospital emergency department, we perform a CT scan to get detailed information about potential causes of stroke and help determine best treatments, including clot-dissolving medications like tPA.

Once you’re stable, you’re admitted to a hospital neuro ICU or stroke care unit for further observation, evaluation, and intensive medical management to start on the road to recovery. It’s a short stay—typically about two days—as we monitor your condition by checking:

• Neurological status – To help avoid falls from not being able to feel the side of the body affected by the stroke
• Vital signs – To help keep blood pressure within certain guidelines
• Swallow response – To help assess muscles affecting your ability to swallow
• Visual field – To help determine vision capacity, especially on the side of the body affected by the stroke

Under the guidance of our physical medicine doctors (physiatrists) and other therapeutic specialists, you begin the stroke recovery and rehabilitation process right away.

And although you’ll leave our hospital and get back to your life as quickly as possible, you’ll never leave our care. After you return home, we continue to provide medical management and follow-up services, including access to stroke support groups for you and your family.