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Carthage, Syracuse hospitals create local stroke center

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CARTHAGE — The hospital here aims to be the first designated primary stroke center in Jefferson County.

Carthage Area Hospital and Upstate Medical University, Syracuse, successfully completed a live trial run Tuesday with a mock exam involving Carthage hospital staff and a stroke neurologist in Syracuse. Now, when patients come into the emergency room at Carthage Area Hospital and it is determined they are exhibiting stroke signs or symptoms, a medical team will work quickly to avoid increased chances of disability or death for that patient.

“Stroke is the No. 4 killer of Americans, and it’s underdiagnosed and not diagnosed in a timely fashion,” said Dr. Mark A. Parshall, Carthage Area Hospital’s stroke chairman and director of the hospitalist program. “As a stroke care center, you have the capacity to administer the dissolving drug within 60 minutes of them hitting the door.”

That is possible with the collaboration of Upstate Medical’s Upstate Stroke Center and Carthage Area Hospital’s new $30,000 computer cart, which links the two hospitals electronically through telemedicine. Richard A. Duvall, Carthage Area Hospital’s chief operating officer, said the equipment was paid for by a Rural Health Access grant.

As Carthage Area Hospital staff is on one end of the system, Upstate’s stroke neurologist can hear and see the stroke patient through the state-of-the-art system. Both hospitals can use controls to see the patient.

Most tests during an exam are about motion and sounds, Dr. Parshall said.

“We’re delighted to partner with Carthage Area Hospital in bringing advanced stroke treatment and care to residents of the north country,” said John McCabe, Upstate University chief executive officer, said in a prepared statement. “Upstate’s mission, as the area’s only academic medical center, is to collaborate on projects just like this and to be a resource for medical professionals throughout the state.”

When patients come into Carthage Area Hospital’s emergency room, they will be triaged by a nurse, and medical staff members will look for any facial drooping, arm weakness and speech changes in a patient. If those signs or symptoms are present, an entire medical team will be at the emergency room within 10 minutes, and within 25 minutes that patient will have a computerized tomography scan. After the CT scans are performed and read, it will be determined whether a patient is eligible for the blood clot-busting medication Activase.

If a patient is not brought into the hospital within three hours of the start of stroke signs or symptoms, Dr. Parshall said, he or she would not be a candidate for Activase. With strokes, he said, timing is everything.

“When you have a stroke, you’ll have a core that gives you your symptoms,” he said. “Around that is an area being deprived of oxygen. You have to have a certain volume of blood to supply oxygen to the brain. The more area of the brain that dies, the larger the stroke will be.”

The advantage of being a stroke center is that a standard of care has to be maintained, Dr. Parshall said. That means no long emergency room waits for people who may exhibit stroke signs or symptoms.

After a stroke patient receives Activase, he or she will be transferred to Upstate Medical University, where the patient will receive expert stroke care, Dr. Parshall said.

Once Carthage Area Hospital and Upstate have completed what they feel is an adequate number of stroke care telemedicine exams, the state Department of Health will complete an assessment in order to designate Carthage Area Hospital as a primary stroke center.

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