Stroke Service
More than 700,000 Americans suffer a stroke each year. Stroke is the leading cause of disability and the third leading cause of death among adult Americans. Mississippi lies in the "Stroke Belt", an area of the country with the highest death rate due to stroke. Our citizens are at especially high risk.
Medical, surgical, and neuro-radiologic therapies are now available to prevent stroke in many people at high risk. Also, new emergency stroke treatments with the potential to significantly reduce permanent disability from stroke are available and under investigation. To reduce stroke death and disability, all Mississippians must be educated to recognize and respond appropriately to risk factors and symptoms of stroke.
Tissue plasminogen activator (t-PA) has been shown to effectively limit the debilitating effects of an ischemic stroke when given within the first three hours after onset of stroke symptoms. When administered outside guidelines or beyond the 3-hour window, the risk of serious complications can exceed the potential benefits from this therapy. Development of educated, rapidly responding teams facilitate appropriate assessment and treatment of acute stroke patients.
The University of Mississippi Medical Center (UMC) has a complete multidisciplinary stroke care team as well as state-of-the-art equipment that enable advanced, high-quality management of stroke patients in an efficient, cost-effective manner.Over 300 acute stroke patients are admitted to the UMC Neurology service each year. In addition several hundred patients with stroke and related conditions are seen annually in outpatient clinics. Along with care of the acute stroke patient, rehabilitation; transition back into the community; continuity of health care; and stroke-prevention are priorities of the stroke team members. UMC Stroke Team members are very active in the areas of public and professional education in the state of Mississippi.
Emergency Stroke management: The Code Gray Team
The UMC emergency stroke management team is called the Code Gray Team, as it is the goal of the team to save the gray matter of the brain. This team, aided by a unified pager system, is composed of members from emergency medicine, neurology, neurosurgery, radiology, nursing, laboratory, pharmacy, and respiratory therapy. This team is experienced in administration of approved stroke treatments as well as clinical trials involving acute stroke therapies.
For urgent ED-to-ED patient transfer contact a UMC ED attending physician by telephone 24 hours/day at 1-888-UMC-2345.
AirCare-transport of patients to UMC by helicopter-is available 24 hours a day and is dispatched as needed by the UMC ED attending. Emergency referrals are welcome, even if the referring physician is not sure whether the patient meets criteria for thrombolysis.
Studies have shown that the use of specialized stroke teams and/or units results in decreased length of stay and improved outcomes.
UMC Stroke Team members include:
| neurologists | neurosurgeons |
| social worker | neurointensivists |
| nurses | neuropsychologist |
| case manager | neuroradiologists |
| occupational therapists | therapists |
| speech pathologists | nurse practitioners |
| physical therapists | dieticians |
| pharmacists |
There have been many advances in secondary stroke prevention strategies and the diagnostic tools available to stroke clinicians. Prevention of a second stroke depends on identification of the cause of the first stroke as well as management of risk factors. Since clinical criteria alone are not sufficient to determine stroke cause, diagnostic testing must be utilized.
Many people do not know that stroke involves the brain, let alone understand risk factors, recognize the symptoms of stroke, or appreciate stroke as an emergency warranting a 911 call.
Hospital Course: A Team Approach
UMC has a Neuroscience Intensive Care Unit and Acute Stroke Unit as well as experienced, well-organized Multidisciplinary Teams that enable enhanced interdisciplinary communication; high-quality, efficient patient care; consistent education of patients and caregivers; and a smooth transition to after-hospital care. Full team conferences are held weekly. On an ongoing basis, team members work closely with other UMC departments and healthcare providers outside of UMC in order to optimize patient care.Secondary Stroke Prevention
UMC provides state-of-the-art diagnostic equipment as well as clinicians experienced with appropriate use and interpretation of studies. Experienced neurosurgeons and interventional radiologists are also available when preventative procedures are required. Follow-up is available in the UMC Pavilion and the Jackson Medical Mall Clinics.Research and Clinical Trials
The UMC Stroke Team is experienced in research efforts involving many aspects of stroke prevention and treatment.Current clinical trials include:
- African-American Antiplatelet in Stroke Prevention (AAASPS): A multi-center NIH-funded stroke prevention study comparing the use of Aspirin and ticlopidine in secondary stroke prevention in African-Americans.
- Warfarin Aspirin Symptomatic Intracranial Disease Study (WASID). A multi-center study comparing the use of Warfarin and Aspirin in patients with intracranial arterial stenosis.
Statewide Educational Activities and the Mississippi Stroke Education Consortium (MSEC)
The University Medical Center, the American Heart Association, IQH-Information Quality Healthcare, Mississippi State Department of Health, and the Mississippi Hospital Association have joined together to form the Mississippi Stroke Education Consortium (MSEC).Data from 1998 stroke screenings
in Mississippi suggests the lack of public knowledge concerning stroke. More importantly, these figures imply an improvement in stroke knowledge after education.MSEC partners with many other individuals and organizations to educate Mississippians concerning stroke. The mission of this organization is "to decrease stroke-related illness and death in Mississippi through education of all of the state's inhabitants regarding stroke - a condition that is quite common in our state and devastating to our people."
Professional education activities sponsored by UMC and MSEC include:
- Annual Stroke Update conferences for physicians and allied health professionals
- Annual Stroke Screening Training Programs for nurses
- Stroke Speakers' Bureau for hospital medical and nursing staffs
- Stroke quality improvement projects through IQH
- Stroke courses for emergency medical services (EMS) personnel.
- Media campaigns for public education
- Stroke Screening Programs
- Speaker's Bureau
For information regarding Speakers' Bureau Activities and other MSEC activities held off the UMC campus, contact the American Heart Association at (601) 981-4721.