The right hospitals for strokes

COUNTY SHOULD REQUIRE THAT VICTIMS ARE TAKEN TO CERTIFIED CENTERS

Mercury News Editorial

Many issues are spun as life and death. Few actually qualify.

One that does is the push for paramedics to send all stroke victims in Santa Clara County only to hospitals that qualify as certified stroke centers. It's not unlike the policy that routes trauma victims to trauma centers.

Not all hospitals are equally capable of handling strokes.

The county's board of supervisors should change ambulance-service protocols to guarantee that future victims are sent to stroke centers with the best equipment and staffing to handle their cases on a 24-hour-a-day basis.

No. 3 killer

Stroke is the nation's No. 3 killer and the No. 1 cause of disability. More than 4,500 county residents are hospitalized by strokes every year at a cost of roughly $300 million.

Yet stroke victims in Santa Clara County are still being taken to the nearest hospital, which may or may not have the equipment and staffing available for optimal treatment. Swift analysis of stroke patients is essential to determine if they are candidates for a potent drug, tPA, that can dramatically bust blood clots. But the drug only works within three hours of a stroke. Fewer than 10 percent of eligible patients make it to the right hospital on time.

The county currently has two certified stroke centers: Stanford Medical Center and Good Samaritan Hospital. San Jose council member Pat Dando had the good fortune to be treated at the latter when she suffered a stroke, but only by chance.

Soon, another choice

A third hospital, Kaiser-Santa Clara, has gone through the certification process and will receive formal designation as a stroke center in January, meaning it has demonstrated that it provides the essential staffing to evaluate and treat patients rapidly enough to make a difference in survival and recovery.

More than 80 percent of stroke victims fail to receive timely care. The county can help dramatically reduce that number by making sure those calling 911 are sent to the hospitals best prepared to handle their cases.