HEART AND STROKE FOUNDATION REPORT REVEALS CANADIANS DON’T GET THE 9-1-1 ON STROKE

Ottawa, June 12, 2008: At least half of Canadians do not treat stroke as a medical emergency, warns the Heart and Stroke Foundation Report on Stroke. In a national poll of adults, the Heart and Stroke Foundation found that less than half would call 9-1-1 if they or someone they know experienced warning signs of stroke.

“With stroke, every minute counts,” says Dr. Sandra Black, Heart and Stroke Foundation spokesperson. “Time is brain. Each minute delay in calling 9-1-1 increases the odds of permanent brain damage, disability or death.”

There is a treatment for the most common form of stroke − strokes caused by a blood clot in the arteries feeding the brain, referred to ischemic stroke − but it must be administered within three hours of the onset of warning signs.

According to the Heart and Stroke Foundation, there are over 50,000 diagnosed strokes in Canada each year. Of every 100 people who have a stroke:

• 15 will die (15%)
• 10 will recover completely (10%)
• 25 recover with a minor impairment or disability (25%)
• 40 are left with a moderate to severe impairment (40%)
• 10 are so severely disabled they require long-term care (10%)

Heart and Stroke Foundation Survey
In a national survey conducted in the fall of 2007, the Heart and Stroke Foundation found that close to three-quarters of Canadians can recognize at least one warning sign of stroke. However, only five out of every 10 Canadian adults aged 18 and over (49%) said they would call 9-1-1 if they or someone they know experienced the warning signs.

HEART AND STROKE FOUNDATION 9-1-1 RISK ASSESSMENT

(% of Canadians who would call 9-1-1 or local EMS if they or someone they knew experienced a stroke warning sign); *Results for Canada can be considered accurate to within plus or minus 2.2 percent, 19 times out of 20

Serious risk: 50-59%; Severe risk: 40-49% ; Critical risk: <40

“It is shocking that only half of Canadians would call 9-1-1 if they or someone they know experienced the warning signs of stroke,” says Stephen Samis, director of health policy for the Heart and Stroke Foundation of Canada. “But what is even more disturbing is the variation in results across the country.

“Canadians need equal access to the best stroke care, no matter where they live,” says Samis. “Coordinated stroke strategies can make a key difference. At the same time, these results also tell us that we still have a long way to go in ensuring equitable access to quality stroke care across Canada.”

Public awareness campaigns on recognizing and reacting to stroke warning signs are an important component of stroke strategies. But increased awareness is only the first step to improving the odds for stroke survivors. Key to surviving a stroke is having access to coordinated stroke strategies able to provide timely and specialized stroke care to patients.

Currently, only three provinces– Ontario, Nova Scotia and Alberta – have sustained, integrated, coordinated stroke strategies that are funded by their provincial governments.

The Canadian Stroke Strategy
“We can and must do a better job of treating stroke effectively and reintegrating people back into their communities,” says Sally Brown, CEO of the Heart and Stroke Foundation of Canada. “That’s why the Heart and Stroke Foundation of Canada and the Canadian Stroke Network created the Canadian Stroke Strategy. It is designed to provide all Canadians with the best stroke care possible, regardless of where they live, by 2010.”

By organizing stroke care through an integrated stroke strategy, we can improve the treatment of stroke – from early identification of warning signs through to immediate diagnosis, targeted treatment, and rehabilitation – and dramatically reduce the impact of stroke, notes Brown.

Widespread access to organized stroke care could prevent more than 160,000 strokes, prevent disability in 60,000 Canadians, and save $8 billion net in health-care costs over the next 20 years in Canada.

Significant progress is being made across the country in implementing organized stroke care. But if individuals experiencing stroke don’t know they are having a stroke and don’t get to the hospital in a timely fashion, the benefits of organized care won’t be realized. To improve access to organized stroke care the Heart and Stroke Foundation has the following recommendations:

Heart and Stroke Foundation recommendations 

To governments:

• Invest in and implement the Canadian Stroke Strategy provincially and nationally.

To physicians:

• Educate patients at risk of TIA or stroke on stroke warning signs and the urgency of getting immediate medical care if experiencing one or more of these signs.
• Reduce your patients’ risk of TIA or stroke
  • Provide information to patients about risk factors and lifestyle management (exercise, diet, weight control, being smoke-free, etc.).
  • Ensure all people at risk of stroke have blood pressure regularly monitored and controlled if necessary.

To pre-hospital and emergency medical service systems:

• Educate first responders on the warning signs of stroke and provide diagnostic screening tools.
• Heighten the emergency response to stroke through priority dispatch.
• Implement protocols and mechanisms to enable the rapid transfer of stroke patients to designated hospitals that provide emergency stroke care.

To regional health authorities and hospitals

• Designate specific hospitals to deliver emergency stroke care and interdisciplinary care in dedicated stroke care units.
• Organize stroke care delivery based on the Canadian Stroke Strategy’s Canadian Best Practice Recommendations for Stroke Care.

To Canadians:

• Learn the stroke warning signs. Go to heartandstroke.ca or call 1–888–HSF–INFO to get more information.  
• Activate emergency medical services if you experience the warning signs or observe someone with the warning signs of stroke: call 9-1-1 or your local emergency number. Stroke is a medical emergency. 
• Play a proactive role in managing your own health. Ask your physician if you are at-risk of stroke and what you can do to reduce your risk.
• Let your government representative know about the benefits of organized stroke care and the need for ongoing government investment.
• People affected by stroke and their families can advocate for change at all levels by telling their story and calling for action.

To research funding bodies and universities:

• Expand research capacity to address stroke prevention, treatment, rehabilitation and community reintegration.

According to the Heart and Stroke Foundation, stroke is the third leading cause of mortality in Canada, accounting for 14,000 deaths every year. Over 50,000 diagnosed strokes occur in Canada each year – that’s one stroke every 10 minutes. Stroke is also a leading cause of adult neurological disability and hospitalization. It has been estimated that there are more than 300,000 Canadians living with mild, moderate or severe disability due to stroke.

The Heart and Stroke Foundation (www.heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.

Posted June 12, 2008.