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N.C.’s Appalachian area impacted by gap in stroke care access in emergency situations

Published: May. 14, 2021 at 3:33 PM EDT
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NORTH CAROLINA (WBTV) - Every 40 seconds - someone, somewhere in the U.S. notices their arm getting weak, their speech slurs, their face droops or feels numb - they’re having a stroke.

From that point, every second matters to get them the help they need.

If it takes too long, they could have a permanent disability or worse, but treatment isn’t always nearby.

Our Bridging the Great Health Divide series is looking at gaps in medical care in North Carolina’s Appalachian area.

Time is everything and in North Carolina, CDC numbers from 2019 show the state has the 11th highest stroke death rate in the country.

It is the fifth leading cause of death in the state.

In Burke County, the stroke death rate has been coming down since 2003 - but it’s still a little higher than the state average. The rate in Burke County is about 19 percent higher than Mecklenburg’s.

Brent Curry is a Physician Assistant with Atrium Health and he’s one of those working to Bridge The Great Health Divide.

“Morganton is actually a very quaint town riddled with a lot of outdoor activities. It’s actually great for family life,” Curry said. “CHS Blue Ridge facilities have a ton of great resources, lots of specialties are readily available. A lot of community leaders that live in the community is really about the people.”

“We see a fair amount of stroke patients who present locally, there’s been a large push over the last several decades to seek stroke care at the most appropriate facility, which is sometimes and most commonly is the local facility. That has been a challenge rurally. throughout time,” Curry said.

Curry says in medicine, professionals know the brain itself is very sensitive to low oxygen levels and the brain is time sensitive. That makes ease of access to stroke care is more important than ever in rural areas.

“So any damage to the brain tissue from a stroke is very time sensitive. A tremendous amount of patients really do not recognize if they’re having a stroke,” Curry said. “When they don’t recognize those symptoms, they delay and feel like it’s going to get better - they are confused about the symptoms. So the American Heart Association has created a lot of education. And there’s a huge education push for patients to detect those signs and symptoms so they can activate faster.”

Time is of consistent significance when it comes to treat patients for stroke symptoms.

“The most important is where we manage the care of dependent on their treatment modalities. But getting a patient here as fast as possible, is absolutely paramount,” Curry said. “A lot of places including Blue Ridge, we have instituted telling neurology 24-hour telestroke care.”

Curry said the 24-hour telestroke care helps with decision making and brings that expertise locally in an area that would not always have access to it immediately.

“When a patient presents with stroke symptoms including the pre-hospital pre alerts that we get when someone’s TMS (transcranial magnetic stimulation), we notify the stroke center and it actually brings on the tele-neurologists and specialty nurses and they do an assessment over telemedicine, which is a wave of the future,” Curry said. “Within minutes when a patient arrives to this facility - which has been something that has crippled rural care over quite some time - it has bridged that gap substantially.”

Curry breaks down what happens when the stroke team is able to assess a patient’s situation through telemedicine.

“The stroke team comes on - they’re actually owned by telemedicine - they assess the patient as we move the patient through the advanced imaging that’s required along with the patient’s symptoms and the assessment by both ourselves and by telling neurology allows us to formulate a plan of care,” Curry said.

Curry talks about the impact a stroke has on a patient for the rest of their lives.

“It’s heartbreaking to see patients who have suffered substantial life-changing events. The quality of life after a stroke is problematic. It changes not only their interaction with their family, families have to provide a tremendous amount of care including home modifications and ramps and stuff that needs to be performed and sometimes it’s difficult so it will sometimes take them out of their place that they’ve been their entire life. And of course with resources they have to fall somewhere else,” Curry said.

Doctors agree the most important thing to do is immediately find medical help if someone has symptoms of a stroke.

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