Grant: Travel Awards - Institute Community Support

An ischemic stroke occurs when a blood clot blocks blood flow to an area of the brain, similar to a clog in a pipe. When this happens the brain becomes deprived of oxygen and irreversible damage begins to occur. Approximately 15,000 Canadians and 7,000 Irish persons experience a disabling ischemic stroke each year. Patients need to be treated quickly after signs of a stroke begin to improve their chance of survival and prevent disability. There are two treatment options for stroke patients: medication to dissolve the blood clot, or surgery to remove the clot. The clot-dissolving drug can be administered at many hospitals across the country but is only effective 30% of the time. The surgical procedure is > 80% effective, but it requires specialized equipment and specially trained physicians so it can only be performed at a few large urban hospitals. This creates a problem for an individual who has a stroke in a rural area because the best treatment (surgical treatment) is not immediately available to this population. It is unknown if it is better for patients to receive quick but less effective treatment (clot-dissolving drug) or to spend extra time transporting patients to the specialized stroke treatment centres for a more effective treatment (surgical procedure). The research outlined here aims to determine the best treatment option given geographical limitations. The objectives of the research will be achieved using statistical models, which will incorporate transport times and information about the receiving hospitals. The result will be an algorithm that will assist paramedic dispatchers in making a decision about where to transport a given rural stroke patient to ensure the best outcome for the patient. This will ensure that all stroke patients, regardless of where they live, receive the best possible care.