A Proud Moment for Tennessee

By: Dr. Blaise Baxter

Yesterday was a good day for Tennessee. It was a good day for those who work in neurology. It was a great day for people in our state who will experience a severe stroke known as an emergent large vessel occlusion (ELVO).

Because yesterday, the Tennessee Legislature passed SB 2513/HB 2167, a bill that will make it possible for more patients to survive stroke.

As many people know, Tennessee sits squarely in the Stroke Belt, which means our rates of stroke are disproportionately high. While I believe firmly in taking all possible steps to prevent serious conditions like stroke through diet and exercise, the reality is that stroke affects nearly 800,000 Americans each year.

Many people don’t make it. Many who do are left with deficits such as mobility and speech impairment that affect them and their families for the rest of their lives. And we know that people are experiencing strokes at increasingly younger ages, even in childhood.

Until we can prevent all strokes, we must have a way to treat them effectively. Neuroendovascular stroke surgery is a procedure that has been proven to do just that. I have used it to save lives, to ensure that people can become independent again after stroke. But far too often, patients who need this type of surgery reach me too late.

This bill addresses this barrier by requiring our Emergency Medical Services Board to develop evidence-based guidelines for how emergency personnel such as EMTs should triage and transport patients. Once such guidelines have been established, ambulance services will have to create and implement their own protocol plans for assessment, triage and transport.

This is important because we know that so many stroke patients end up at hospitals that are not equipped to treat them. With no protocol dictating where stroke patients go, people often end up at the nearest hospital, which may or may not have the capacity to treat them.

Comprehensive, or Level 1, stroke centers are staffed 365/24/7 with care teams that are trained to provide the endovascular stroke therapy that gives patients the best chance of surviving and thriving after stroke. This is where we need to be taking stroke patients, particularly the ones who are experiencing an ELVO.

Likewise, regular training will be required for emergency personnel regarding how to assess and treat strokes, including emergent large vessel occlusions and other types of severe stroke. This is important because, despite stroke being the fifth leading cause of death in our state, stroke cases represent only about 1 percent of the caseload for EMTs. It can be easy for stroke triage to fall through the cracks.

As a physician practicing in Tennessee, I’m very proud that our state has demonstrated to the country that we can improve stroke systems of care simply by addressing the triage and transport of stroke patients. I hope others will follow suit.

As the sitting president of the Society of NeuroInterventional Surgery, I am likewise proud that our Get Ahead of Stroke campaign, which has for two years been working to raise public awareness and advance advocacy efforts about the effectiveness of neuroendovascular stroke surgery, has taken a huge step forward in helping Tennesseans survive stroke.

Blaise Baxter, M.D., is an interventional neuroradiologist in Chattanooga, Tenn., and president of the Society of NeuroInterventional Surgery