Illinois Law Requires Stroke Patient Transport to Primary Stroke Centers

In most medical emergencies, the goal is to get an ill or injured person to the closest hospital emergency department for care.

But when it comes to stroke, Illinois lawmakers say patients should be transported to the nearest Primary Stroke Center, a designation carried by only 26 hospitals in Illinois. Ingalls Memorial Hospital in Harvey is one of them - and one of only two hospitals in the south suburbs to hold the designation.

Last month, Gov. Pat Quinn signed into law a bill to establish a network of specialty stroke centers in Illinois and allow ambulances to take patients suffering a suspected stroke to these facilities, bypassing other nearby hospitals.

"Stroke is the leading cause of disability and the third leading cause of death in the United States," said neurologist Dr. Engin Yilmaz, medical director of the Ingalls Stroke Center.

"The goal of the legislation is to minimize the damage caused by stroke and get patients to the most appropriate treatment facility as soon as possible. Numerous studies have shown that stroke patients receive better care and experience better outcomes when they are at a Primary Stroke Center like Ingalls."

To qualify as a Primary Stroke Center, hospitals must have the following criteria in place at all times:

Written emergency stroke care protocols.

A written transfer agreement with a hospital that has neurosurgical expertise.

A director of stroke care to oversee hospital stroke policies and procedures.

The ability to administer clot-busting drugs, such as tPA.

The ability to conduct brain image tests, such as CT and MRIs, at all times.

The ability to conduct blood coagulation studies at all times.

Maintenance of a stroke patient log, available for review by the IDPH.

Under the new law, care for stroke patients would be organized similar to the current system for treating patients with major trauma. Ambulances typically transport major trauma patients to hospitals that offer specialized trauma care - instead of the nearest hospital ER.

"Hospitals with a specialty stroke center designation, like Ingalls, have the resources and the ability to rapidly assess a suspected stroke and offer recommended treatments such as tPA promptly, minimizing the possibility of long-term disability," Yilmaz said.

Diane Luif, of Lynwood, knows that first-hand. Two years ago, then 50-year-old Luif suffered a transient ischemic attack traveling in the car with her husband and daughters. Her speech became slurred, and her left side was nearly paralyzed.

Her quick-thinking family drove her to Ingalls, where Luif underwent a CT scan. While initial tests showed no signs of an acute stroke, Luif was admitted to the hospital's inpatient stroke unit for further evaluation.

"When they came to get me for an MRI, I got up out of bed and went right down," Luif said. "My left side was paralyzed."

A nurse's assistant at Ingalls activated the hospital's stroke protocol. Within minutes, Luif underwent the MRI, which confirmed a stroke. She was evaluated by Yilmaz and given the clot-busting drug tPA, a thrombolytic agent that breaks up blood clots that cause stroke.

The quick action not only saved her life, it spared her permanent disability. Just a couple of days after her stroke, she was discharged from the hospital and began rehabilitation at Ingalls Center for Outpatient Rehabilitation in Calumet City.

"When it comes to treating stroke, time is of the essence," Yilmaz said.

Two months later, Luif was back at work and fully functional.

"It was such a blessing that I was right where I needed to be when this happened," she added.

In 2008, Ingalls' stroke care program earned the Gold Seal of Approval from the Joint Commission for Primary Stroke Centers.

The hospital's multi-disciplinary team covers all aspects of stroke care, from prevention and diagnosis to acute care and rehabilitation.

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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.