Many years ago, thrombolytic therapy was approved for the acute treatment of a stroke. Despite this therapy, very few patients are receiving treatment in time to prevent stroke sequela. There are several explanations for the failure to diagnose a stroke and the failure to timely treat a stroke.
First, many patients wait too long to go to the hospital after experiencing stroke symptoms. On average, patients alone at symptom onset waited more than three and one-half (3.5) hours to go to the hospital (as compared to roughly 2 hours for those not alone). Awakening from a sleep with symptoms increases delay. Transport to the hospital by emergency medical services decreases delay.
Second, many hospitals wait too long after a patient arrives in the emergency department to obtain a CT scan, the results of which may result in a stroke diagnosis and prompt thrombolytic therapy. On average, hospitals take just over 1 hour to perform the diagnostic study. A hospital may depart from accepted standards of care, an be liable for hospital negligence or medical malpractice, for exceeding time standards set by the a National Institute of Neurological Disorders and Stroke advisory committee.
In sum, delay in presenting to the hospital, when joined with hospital delay, can lead to a failure to timely diagnose a stroke and, in turn, a poor outcome such as brain damage.
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