Mo. bill sets new guidelines for stroke, heart attack care

Monday, July 14, 2008

SPRINGFIELD, Mo. -- Stroke and heart attack patients in Missouri could get faster, better help that will improve their chances for survival under a new state law.

Legislation signed by Gov. Matt Blunt on Friday created a "Time Critical Diagnosis System" for stroke and a fatal type of heart attack called ST-elevation myocardial infarction, or STEMI.

The legislation requires emergency medical services to take people with acute stroke and STEMI to a designated center of care first, rather than taking them to the closest facility, said Dr. Scott Duff, who led the task force that developed the legislation.

"The sooner we treat people, the better they do," said Duff, of CoxHealth in Springfield.

Incoming stroke patients will get "reperfusion therapy," or tPA, a clot-busting drug, as soon as possible, Duff said.

After a stroke, doctors have about three hours to try to get blood flow back to the brain.

"If we waste time in the transport of a patient to an appropriate center, we lose the chance to save brain cells," Duff said in a news release. "The sooner we treat people with ... the clot-busting drug, the better they do. It's the difference between the patient going home, going to a nursing home or dying."

Duff predicted the system would reduce the $750 million or more that Missouri spends on direct and indirect stroke care costs.

The task force included more than 100 people involved in the state's emergency medicine community. It was led by Dr. William Jermyn, state emergency medical services director, who died of a heart attack earlier this year.

"His goal was to get the 'Right care, right place, right time,' said Carol Beal, director of St. John's Stroke Program in Springfield.

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