Video Transcript
When you’re talking about a failure to diagnose stroke case, you want to know is it an ischemic stroke, which is where a clot obstructs a blood vessel and causes an inability for blood flow to get to tissue that, if tissue dies off because of the clot, can convert into a hemorrhagic stroke. Some strokes begin as hemorrhagic strokes, which is just uncontrolled bleeding. The reason that’s important is if you have an ischemic stroke, there are medications called thrombolytics that can be given within a very short period of time—a window from the first sign or symptom of the stroke until an outer window of anywhere from four to six hours. If the stroke is recognized, it is worked up, it is diagnosed, and thrombolytics are administered during that window, it significantly increases the patient likelihood of surviving the stroke and of surviving it with minimal, if any, injuries from the stroke. However, if an ischemic stroke is not recognized within that window, thrombolytics are actually more dangerous after the fact because there is the risk that the ischemic stroke is now converted to a hemorrhagic stroke, and the last thing you want to do is give that person medications that could cause the bleed to be worse. So, first of all, deciding is it potentially a stroke? If so, what type of stroke is it? And if it is indeed an ischemic stroke, am I within the window to give this patient thrombolytics? Those are the three most important questions, and if any one of those is answered incorrectly, the consequences are catastrophic to the patient.
