“San Jose is lucky to have the Stroke Awareness Foundation educating the public about stroke, and helping hospitals and emergency personnel to respond more rapidly. Such efforts have been very successful in Texas, where we used a similar approach of community education and training of hospital and emergency medical personnel to increase the number of stroke victims who could be administered t-PA.”

James C. Grotta, MD
Professor of Neurology
University of Texas
Houston Medical School

Stanford Stroke Center

“The Stroke Awareness Foundation has made a spectacular effort to encourage certification of local stroke centers and paramedic diversion of acute stroke patients to appropriate care facilities. This effort will likely have a major impact on public health in our areas.”

Gregory W. Albers, MD
Director
Stanford Stroke Center

Good Samaritan Hospital

“The Stroke Awareness Foundation has been particularly helpful to our staff at Good Samaritan Hospital as we worked to become a Certified Stroke Center.”

William K. Piche, CEO
Good Samaritan Hospital

Charles E. Hoffman, a retired San Jose importer of machinery and parts, suffered his stroke in 1997 and was one of the first stroke patients at the Good Samaritan Hospital to be treated with t-PA and to experience no side effects.

During 2001, Patricia Dando, Vice Mayor of the City of San Jose, suffered a sudden weakness in one side, but did not realize that her symptom was a sign of stroke. Initially she was going to wait to see if she felt better before seeking help. Fortunately she arrived at Good Samaritan Hospital within the three-hour window were she was diagnosed as having a partial blood blockage in the brain and was successfully treated.

Charles J. Toeniskoetter, a San Jose-based commercial building contractor and developer, experienced a particularly harrowing brain attack in 2000 when his entire right side was paralyzed after a day of downhill skiing in Bear Valley, high in the Sierra Nevada. A helicopter would have flown him to a hospital unequipped for treating stroke if a land-based paramedic had not clung to the door insisting that Mr. Toeniskoetter go instead to Sutter Roseville Medical Center. He arrived just within the three-hour deadline for using t-PA to dissolve the blood clot and has fully recovered.

A San Jose woman was successfully treated with t-PA at Good Samaritan Hospital well within the three hour window because her husband correctly identified her symptoms and immediately took her to the hospital. The husband had attended a presentation on stroke by Stroke Awareness Foundation Chairman Chuck Hoffman at The Villages in San Jose, where he was given a wallet card listing stroke symptoms and urging immediate action.

A Long Beach woman was successfully treated for stroke soon after she called her San Jose daughter and son-in-law for help. The son-in-law had attended a speech by Stroke Awareness Foundation Board Director Chuck Toeniskoetter at the annual American Heart Association luncheon in San Jose. Based on what he had learned, the son-in-law helped direct the stroke patient to a hospital in Los Alamitos that treated her successfully with t-PA.

Paramedic transport was the most important factor in reducing delays in arrival on stroke patients at emergency rooms. Increased accuracy of paramedics in diagnosing stroke and efficient pre-hospital treatment and support were key.

Historically, paramedic services were decentralized and scattered around the city, and were served by competing ambulance companies. These conditions made it difficult to orchestrate training and communications between paramedics and stroke centers.

This project was sponsored in east Texas after a prominent Chamber of Commerce leader suffered a stroke. A multi-level community communication campaign combined with professional development and organizational change significantly increased access to acute stroke therapy.

Focus was put on the interaction and education between various groups. Education on stressing the need for urgent care for patients and bystanders interacting with paramedics, as well as educating primary care providers that requiring to see a patient in ED can delay the possibility of treatment.

The results among stroke victims who were eligible for t-PA:

• 14% were successfully treated in phase 1 (1998)
• 52% were successfully treated in phase 2 (1999)
• 69% were successfully treated in phase 3 (2000)
  6 months after intervention ended