Stroke Education

UMMC is a Joint Commission Certified Comprehensive Stroke Center. We are working towards Joint Commission Certification for Comprehensive Stroke Center. The following module provides education related to stroke care at UMMC and fulfills requirements for Joint Commission Disease Specific Care Certification.

Objectives: Review, Understand, and Pass Quiz 

• UMMC is a Comprehensive Stroke Center by The Joint Commission
• Stroke Center 2023 updates
• Why is stroke important to me
• What are the types of stroke and specific stroke risk factors
• What do I do if I suspect someone is having a stroke

UMMC Stroke Center: The Joint Commission Certification

What are we?

• In August 2014, we were certified as a  Primary Stroke Center (PSC) by The Joint Commission (TJC). This is a national certification.
• We were recertified in 2016, 2018, and 2021 as a PSC after a one day survey by TJC.

What are we now?

• We achieved Comprehensive Stroke Center in March 2023.

Why is stroke important to me?

• As part of being a nationally-certified TJC Primary Stroke Center.
• MS is part of the “stroke belt” – eight southeastern states with about  30% or more deaths due to stroke compared with rest of nation. 
• Stroke is the seventh leading cause of death in Mississippi. (CDC 2020)
• MS has highest death rate in nation > 1900 deaths. (CDC 2020)
• Approximately 795,000 new or recurrent strokes (hemorrhagic and ischemic) occur yearly.
• Approximately 610,000 are first events.
• Approximately 185,000 are recurrent events = shows importance of stroke education while in the hospital!
• About every 40 seconds someone has a stroke, and about every 4 minutes someone dies of stroke.

MS ranks 49/50 in deaths as a result of stroke

Visit the CDC Interactive map to see where Mississippi ranks in comparison to other states in regards to stroke: CDC Interactive Data Map

Recent annual stroke data from Centers for Disease Control and Prevention:

What is a stroke?

A stroke is sometimes called a brain attack:

• Stroke occurs when a blood clot or plaque blocks an artery, or when a vessel breaks.
• Interrupts blood flow to an area of the brain.
• Results in death of brain cells in the surrounding area of the brain.

Sudden Neurologic Changes – BEFAST (see below) and possibly sudden confusion, numbness especially on one side of body, vision loss, trouble walking, severe headache with no known cause.

B E F A S T

• B = Loss of Balance
• E = Eye(Loss of Vision)
• F = Face Drooping
• A = Arm Weakness
• S = Speech Difficulty
• T = Time to Call 911 OR  4-1111 if this is an inpatient already

www.strokeassociation.org, reviewed online September 2023

Types of stroke

1. Ischemic (Clots) -

Ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases.

2. Hemorrhagic (Bleeds) -

Hemorrhagic stroke occurs when a weakened blood vessel ruptures. Two types of weakened blood vessels usually hemorrhagic stroke: aneurysms and arteriovenous malformations(AVMs). But the most common cause of a hemorrhagic stroke is uncontrolled hypertension (high blood pressure).

Note the national vs 2021 UMMC stroke breakdown below.

https://www.stroke.org/en/about-stroke/types-of-stroke retrieved September 2023 Allscripts for UMMC data, reviewed August 2020

Risk factors for stroke that can be controlled?

• Hypertension – high blood pressure is the number one cause of stroke and is the most controllable risk factor for stroke.

• Diabetes Mellitus – having Diabetes independently increases risk for a stroke. Coupled with obesity, high cholesterol, high blood pressure and/or other risk factors, it can greatly increase stroke risk.

• Dyslipidemia – elevated LDL causes damage to the blood vessels.

• Atrial Fibrillation – having a type of “irregular heart rate”- clot formations in the heart can travel upstream to the brain.

• Smoking – causes significant damage to blood vessels.

• Drug/Alcohol Use – Alcohol and drug use can increase risk for stroke.

  https://www.stroke.org/en/about-stroke/stroke-risk-factors/stroke-risk-factors-you-can-control-treat-and-improve, reviewed online September 2023

What do I do if I see someone I suspect is having a stroke?

If you are inside University, Wiser, and the Critical Care Tower or in patient service areas in the original adult hospital:

• Call 4-1111. Ask to activate Code Stroke. Give exact location in the hospital.

If you are on the grounds of UMMC not in the patient care areas above:

• CALL 911!

Move fast!!!!!!!

• Treatments to stop the stroke in progress are available if you get there quickly!

Questions?

• Neal Kiihnl, UMMC Stroke Manager, 601-984-4811

Test Questions

1. UMMC is a nationally certified Comprehensive Stroke Center through The Joint Commission. 

   1. True

   2. False

2. What acronym helps to remember the signs and symptoms of stroke?

   1. RACE

   2. BEFAST

   3. CSC

3. You see a patient laying on the grass by State Street as you are walking in to work one morning. You suspect a stroke. What number would you call?

   1. 911

   2. 41111

4. You are working on an inpatient floor and you note a new change with an admitted patient - they cannot move one side of their body. What number would you call?

   1. 911

   2. 41111

5. The most common cause and most controllable risk factor of stroke is:

   1. Diabetes

   2. Atrial Fibrillation – “irregular heart rhythm”

   3. Longstanding uncontrolled HTN

Answers:

1. A
2. B
3. A
4. B
5. C

References

• Emelia J. Benjamin, Salim S. Virani, Clifton W. Callaway, Alexander R. Chang, Susan Cheng, Stephanie E. Chiuve, Mary Cushman, Francesca N. Delling, Rajat Deo, Sarah D. de Ferranti, Jane F. Ferguson, Myriam Fornage, Cathleen Gillespie, Carmen R. Isasi, Monik C. Jiménez, Lori Chaffin Jordan, Suzanne E. Judd, Daniel Lackland, Judith H. Lichtman, Lynda Lisabeth, Simin Liu, Chris T. Longenecker, Pamela L. Lutsey, David B. Matchar, Kunihiro Matsushita, Michael E. Mussolino, Khurram Nasir, Martin O’Flaherty, Latha P. Palaniappan, Dilip K. Pandey, Mathew J. Reeves, Matthew D. Ritchey, Carlos J. Rodriguez, Gregory A. Roth, Wayne D. Rosamond, Uchechukwu K.A. Sampson, Gary M. Satou, Svati H. Shah, Nicole L. Spartano, David L. Tirschwell, Connie W. Tsao, Jenifer H. Voeks, Joshua Z. Willey, John T. Wilkins, Jason HY. Wu, Heather M. Alger, Sally S. Wong, Paul Muntner. Heart disease and stroke statistics – 2018 update: A report from the American Heart Association,Circulation. 2018;137:XX-XX. DOI: 10.1161/CIR.0000000000000558

• www.stroke.org

• www.cdc.gov