PCMH certified as Primary Stroke Center, the only one east of I-95

Written By  Jimmy Ryals  on  9/17/2007 6:53:42 AM
GREENVILLE -- Following emergency treatment for stroke in July, Princess Ransdell was amazed to learn that Pitt County Memorial Hospital was not a primary stroke center. The Greenville resident didn't know what a primary strokecenter was exactly, but it sounded like the place where you'd get the best stroke care around.

"I tell you, I couldn't have gotten better care," said Ransdell. So why, she wondered, wasn't PCMH a primary stroke center?

It is now. On Thursday, the Joint Commission awarded primary stroke center certification to PCMH, making it the only North Carolina hospital east of Interstate 95 to bear that distinction. The Joint Commission, the nation's largest standards-setting and accrediting organization in health care, visited PCMH for a one-day on-site survey last month.

Certification means that a hospital maintains the trained staff and dedicated resources to consistently follow the accepted best practices in its treatment of stroke. In short, it means the hospital provides the best possible stroke care, 24/7.

"Achieving certification means that we are committed to stroke care, and that we are in it with our patients," said Susan Freeman, PCMH stroke nurse practitioner. "We're here to hold their hands through the process. We don't leave them once they get their treatment; we're here all the way across the continuum of care."

In specific, certification means a hospital must have, among other resources, a dedicated stroke-response team whose members can be pulled together at first indication a patient may have had a stroke. At PCMH, a "code stroke"is called to immediately assemble its response team.

Equally essential to certification is a hospital's availability of tissue plasminogen activator, commonly known as tPA. This clot-busting drug is the only FDA-approved medication for treatment of ischemic stroke, or the blockage of a blood vessel in the brain. Ischemic strokes account for more than 80 percent of all stroke cases.

Administered within a crucial three-hour window following stroke, tPA can produce startling levels of recovery, even to the point where there's no outward evidence a patient ever had a stroke, as in Princess Ransdell's case.

"It's a good feeling to know that if a stroke patient comes in this door, and they have the potential to get better, that we have the treatment to get them better," Freeman said. "Then to see them walk out of the door after they came in and couldn't walk and couldn't talk, you can't put a dollar value on that."

But timing of treatment couldn't be more crucial, emphasized Dr. Rodney Leacock, medical director for the PCMH Stroke Center. "Time lost equals brain lost," he said.

Leacock hopes the primary stroke center designation will help reduce the burden of stroke on eastern North Carolina by providing rapid access to care.

But treatment isn't all that's involved in being certified a primary stroke center, Leacock added.

"Certification also formalizes a hospital's commitment to educating the public on stroke, and stroke prevention," he elaborated.

One common perception in eastern North Carolina -- often called "the buckle of the stroke belt" due to the region's extraordinarily high incidence of stroke -- is that stroke is just one of those things that comes with old age, and that nothing can be done about it.

Not true, said Freeman. "The public needs to know that they need to get here immediately if they believe they or a loved one may have had a stroke, and that it's not OK to have a stroke."

Stroke facts
  • Stroke is the third-leading cause of death, and the leading cause of disability, in this country.

  • In eastern North Carolina, stroke risk factors run very high: 70 percent of Pitt County Memorial Hospital patients treated for stroke also have high blood pressure, nearly 30 percent are also diabetic and about 15 percent regularly use tobacco products.


  • Stroke symptoms
  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

  • Sudden confusion, trouble speaking or understanding

  • Sudden trouble seeing in one or both eyes

  • Sudden trouble walking, dizziness, loss of balance or coordination

  • Sudden, severe headache with no known cause


  • If someone is displaying any of those symptoms, then perform this simple F.A.S.T. test.
    F - Face. Ask the person to smile. Does one side of the face droop?
    A - Arms. Ask the person to raise both arms. Does one arm droop?
    S - Speech. Ask the person to repeat a simple sentence. Are the words slurred? Is the person unable to repeat the sentence correctly?
    T - Time. If you answer yes to any of those questions, time is of the essence! If it is a stroke, the longer you wait, the more brain cells die. Call 9-1-1 immediately. "It's always better to err on the side of caution then to say, 'Oh, well, I'll lie down and I'll feel better in the morning,' and then you get up and you cant walk or talk," said Susan Freeman, stroke nurse practitioner at Pitt County Memorial Hospital.