Department of Neurology, Chongqing Seventh People's Hospital: 17 minutes to make stroke dangerous

Time is the brain, time is life - Chongqing Seventh People's Hospital (referred to as: The Seventh People's Hospital of Chongqing) New Year stroke first aid record.

At 14:00 on the afternoon of January 2, 47-year-old Mr. Li had just finished a small gathering with friends, and suddenly felt that his left limb was weak and it was difficult to stand and walk. At first, Mr. Li thought that he had been sitting for a long time and wanted to stand up and move, but the symptoms of weakness in his left limb continued to worsen, and even his left hand was unable to hold things, and his left leg could not be lifted.

Mr. Li then remembered the classmates who worked in the hospital, after consulting the situation, the phone was turned over several times to the hands of Li Xunjun, director of the Department of Neurology of the Seventh Hospital of the City, Li Xunjun listened to the patient's situation, and immediately instructed the patient's family to find a way to rush to the hospital as soon as possible without affecting the patient's life, and the patient was likely to have a stroke.

Subsequently, Li Xunjun immediately notified the medical staff of the emergency department and the stroke team to prepare according to the stroke treatment process.

At 16:00, the patient arrived at the hospital, after preliminary assessment, NIHSS score of 6 points (neurological defect score, the higher the score means that the more serious the disease), nucleic acid collection, blood glucose check, electrocardiogram, blood draw, establishment of intravenous channels, early preparation of the treatment team in 5 minutes to complete a series of processes.

At 16:05, the patient was transferred out of the emergency room, and the nurse aunt on duty at the elevator was already waiting on the first floor.

At 16:10, the patient arrived at the CT room, and the technician of the radiology team of the medical imaging department had opened the screen door of the CT room, and the doctors and nurses of the stroke rescue team were waiting in place.

▲Left: The skull DWI shows lesions of the hind limbs of the right inner capsule

Right: Head and neck vessel CTA suggests rough RMA wall

At 16:15, no bleeding was seen at the end of the patient's head CT scan.

At 16:17, after the signature of the family, the treatment team performed alteplase intravenous thrombolysis for the patient in the CT room.

At 17:17, the intravenous thrombolysis ended, the patient's NIHSS score was 0, and the patient's and family's hanging hearts gradually relaxed.

This is a race against time for treatment, acute ischemic stroke for every minute delay, brain cell death of 1.9 million, Mr. Li DNT time (refers to acute stroke patients into the hospital to the start of intravenous thrombolysis to start administration time) only 17 minutes, was successfully treated and achieved good efficacy, can not be separated from the city's seven hospitals in the process of the construction of the national stroke prevention and control center established the acute stroke treatment process.

At present, under the personal deployment of the hospital leadership team, under the close cooperation of neurology, neurosurgery, emergency department, medical imaging department, laboratory department and other related departments, the seventh hospital of the city has obtained the national stroke prevention and control center license, in 2021, nearly 100 cases of intravenous thrombolysis, 3 cases of arterial thrombolysis, accumulated rich clinical experience, established a standardized stroke treatment process, and the construction of stroke center has gradually shown results. At the same time, in 2021, the Seventh Municipal Hospital also held two district-level stroke academic conferences, which promoted the development of regional stroke treatment.

Liu Anbin, vice president of the Seventh Municipal Hospital, encouraged in the working group that the treatment was during the holiday period, and the relevant functional departments, clinical, medical technology and logistics departments cooperated skillfully and jointly to achieve satisfactory results for patients, which is also the actual embodiment of the construction results of the Stroke Center of the Seventh Hospital of the City, hoping to transform the standard into habits, and continue to carry out work to provide effective and satisfactory treatment services for every stroke patient.

Vice President Zhu Yu also emphasized the future work focus of the stroke center, to further standardize the reception and thrombolytic process; strengthen the collaboration of various disciplines, continue to improve the bridging treatment rate; strengthen stroke publicity and training, improve early recognition ability and awareness of the thrombolytic time window; strengthen the training of medical community personnel, expand the radius of treatment services; and strengthen the online science popularization of stroke knowledge. (Text/Li Xunjun Photo/Chongqing Seventh People's Hospital)