Even under ideal circumstances, strokes are challenging to treat. The longer it takes to begin care, the greater the risk a patient will be seriously impaired. However, acute care physicians must also work carefully, as a poorly chosen treatment can worsen the condition. COVID-19 has added new layers of complexity.
“Emergency departments have been stretched thin from COVID,” said Ivette Motola, M.D., M.P.H., an emergency medicine physician and assistant director of the Michael S. Gordon Center for Research in Medical Education at the University of Miami Miller School of Medicine, which supports medical education. “In addition, some stroke patients have COVID, which complicates their care. Some patients delay seeking care because they’re afraid of COVID, and some younger patients are presenting with stroke because hypercoagulation is one of COVID’s potential side effects.”
To help providers cope with these many issues, Dr. Motola and Gordon Center colleagues have worked with the American Heart Association (AHA) to develop an online class for emergency providers. Called Stroke Care During the COVID-19 Pandemic, the course describes best practices during this pandemic, as well as the science backing them up. The goal is to help caregivers provide the best possible care, while doing everything possible to prevent infection.
Safe care in a timely manner
“We try to give health care providers information on how to safely care for stroke patients and still do it in a timely manner,” Dr. Motola said. “That’s one of the challenges during the pandemic. We have to make sure we’re protecting the patients and ourselves, while also recognizing that stroke care is time-sensitive, and we have to perform a lot of tasks in a short period of time.”
The class was a new collaboration between the Gordon Center and the AHA and built on the Gordon Center’s previous experience with teaching stroke to health care professionals globally through its Advanced Stroke Life Support program. So far, more than 1,200 clinicians from around the world have taken the class, including providers from the U.S., Europe, Southeast Asia and the Middle East.
Both the Gordon Center and AHA hope this class and other measures will help increase patient confidence. One of COVID’s more insidious consequences is that patients are reluctant to visit the emergency department, even when they’re having clear symptoms.
Dr. Motola notes there has been a 30% to 40% decrease in the number of heart attack and stroke cases presenting to hospitals in the hardest hit areas, since the pandemic began. This is deeply troubling because people are still getting sick — they’re just not seeking the care they urgently need.
“People are afraid to go to the hospital and that can really compound the severity of a stroke,” Dr. Motola said. “One of the biggest things to understand is that this is an emergency, and time is brain. If you think you or a loved one is having a stroke, you need to immediately access the health care system by calling 911 as soon as possible.”