Urgent Care For Stroke Victims – We Can Do Better!

This article is all about expanding our regional hospitals’ emergency room authority.

Army M.A.S.H. (Mobile Army Surgical Hospital) unit have had the ability and authorization to take action on medical emergencies that required quick action and attention on serious war-time injuries in order to preserve life.  Canyon Vista Medical Center is located in Sierra Vista, Arizona, a small community with an emerging retirement population.  Canyon Vista is a relatively new facility that opened its’ doors in April of 2015 and is quite fortunate to have interventional cardiologists, certified for brain bleed/clot removal.  What Canyon Vista lacks is having highly specialized neurosurgeons on staff to monitor brain bleed/brain clot removal.  However, what Canyon Vista does have and is equipped with is the ability to have live video/web support from specialized medical experts in brain/bleed/stroke situations.

The above is very important and very close to my heart – and I am very passionate about this.   As a retired engineer of international safety acclaim, I want to be an advocate for my wife Nancy, who suffered a brain attack in January of 2016 and to be an advocate for our community on providing this specialized care for local residents.    My wife was rushed to Canyon Vista emergency room (ER) within minutes by the fine services of our Sierra Vista Fire Department following her stroke at our home.  At the hospital, Nancy was quickly diagnosed via live video by a highly qualified doctor as a victim of a massive brain clot/bleed and instructed the ER team at Canyon Vista to have her air-lifted immediately to the Tucson Medical Center (TMC), a flying distance of about 30 minutes.  This policy does ensure the best of medical care, however, it extends the extremely critical time for the clot to be removed.  What the ER team at Canyon Vista did provide was a “clot-buster” injection before being air-lifted out of Sierra Vista to Tucson.

Immediate attention was provided upon Nancy’s arrival.  However, the cardiologist that removed the clot was not able to provide any good news on my wife’s condition.  The delay on transporting her from Sierra Vista to Tucson had caused irreversible damage, physically and mentally.  Nancy had paralysis on her right side with no use of her right arm and leg but she was able to maintain her sunny and loving disposition, however her speech was slowed considerably with the ability to only speak one or two words, unable to manage a full sentence.

Nancy was released from TMC to a rehabilitation center nearby.  Following three weeks of care, she was transported to the Life Care Center in Sierra Vista.  Nancy endured six months of care and rehabilitation, however showing no sign of improvement.  A woman of very strong faith gave up, gave in, and resigned, freeing herself from the disabling brain damage the massive brain clot/stroke had cursed her with.  Sadly, Nancy passed away in July of 2016.

Let me be clear, our medical profession and support facilities of hospital emergency rooms are NOT to be blamed.  Our hospitals and regional medical centers are held hostage by vague federal medical requirements and “foolish” insurance company risk management rules!

The TMC cardiologist who removed Nancy’s blood clot may have assumed that 90% of victims that are air-lifted to TMC with medical neurosurgeons physically available are only always needed less than 10% during the procedure to remove the clot. This is where you see how our federal rules and insurance companies hold our medical professionals hostage.  Our emergency room care needs to address the percentage of patients/victims of a brain bleed/stroke who are air-lifted to a larger city with a larger hospital presence, who will NEVER fully recover due to oxygen being blocked to the brain for more than 30 minutes.

Our United States Army Combat M.A.S.H. units performed miracles during the North Korean and Vietnam conflicts.  These units were able to provide immediate emergency surgery for our wounded warriors needing immediate attention.  Their lives depended on these M.A.S.H. units to address the most urgent need vs. being transported to a military hospital to be attended by a host of medical professionals, thus losing the valuable “time” that was needed for a complete and successful recovery.

What our regional medical centers emergency rooms do need is the LEGAL IMMUNITY that our United States Army M.A.S.H. units have.  The percentage of patients/victims air-lifted to a larger hospital 30 minutes or more away will always have a negative outcome due to that very critical DELAY on removing the blood clot.

It is beyond ridiculous that patients of a deadly stroke cannot be provided the live video presence of neurologists and neurosurgeons located at larger, well-equipped hospitals specializing in the removal of brain clots. This service is needed to receive immediate diagnosis, expert medical advice and necessary support to the regional medical center emergency room staff that are in the city/location for the immediate removal of a brain clot.    Our medical profession and professionals, with all the nuances of today’s medical technology, should NOT be restricted by inane rules that inhibit the necessary and reasonable emergency medical treatment to provide the best medical care and technology to a community they serve.

Let’s welcome and not inhibit medical innovation due to crazy federal and medical insurance concepts.  Let our medical professionals be all that they can be, utilizing their knowledge from all their years and experience in medical school and medical practice in performing the medical miracles that they have been educated and trained for.

I would like to share a story that a WWII Bomber Squadron Commander had shared with me years ago: Near the end of WWII, flying over Germany, a tail gunner in a U.S. bomber was struck in the shoulder by a bullet from a Nazi fighter jet.  Bleeding could not be stopped, and it would be six hours before reaching England.   The tail gunner did not have six hours to survive the wound and needed immediate medical attention or he would die. The squadron commander knew of the location of a German-controlled military hospital that was nearby and re-routed the flight towards this Army hospital.  The air crew bandaged the tail gunner the best they could with what medical supplies they had on board to at least slow down the bleeding.  When flying over the German hospital, and with great hesitation, they ejected the tail gunner from the aircraft’s bomb-bay by parachute and hoped for the best.

Within one month, WWII was over and the squadron commander was summoned to meet with General Eisenhower and could only wonder what wrong he had done.  However, General Eisenhower had quite a surprise for him.  First by being flown in a private plane and second, being flown to a secret location.  It was soon apparent that he was being flown to the German Army hospital where he had made that tough decision to parachute the wounded soldier one month prior.  Upon landing, they taxied to a red carpet and greeted by Germany’s top medical general and the injured tail gunner!  The German medical general extended his hand and said:  “We knew the war was nearly over and we did the best we could for your wounded gunner.” At that point, the squadron commander realized the very happy medical outcome for the tail gunner with their decision to parachute him to the closest medical hospital for care and treatment.

We need a happier outcome than what was my wife’s experience. We need to provide innovation and remove restrictions.  Allowing regional medical center emergency rooms the ability to work via live video with a neurologists and neurosurgeons who specialize in brain bleeds/clots and to remove the brain clot right there and then – IMMEDIATELY!!!  Let’s have a better outcome for those who suffer a brain bleed/stroke when transported to their local, regional medical center.

David V. MacCollum

We do not need lawsuits to prove the necessity for this urgent care.  When the German medical general was able to do the “best” they could for the wounded tail gunner, we MUST allow our medical profession and professionals to do the “best” they can for our citizens.

This procedure is a MUST NEED for all medical centers and hospitals across the nation for the sake of all brain bleed/stroke victims.

About David V. MacCollum 56 Articles
David V. MacCollum is a past president of the American Society of Safety Engineers and was a member of the first U.S. Secretary of Labor's Construction Safety Advisory Committee [1969-1972]. He is the author of: Construction Safety Planning (Jun 16, 1995) Crane Hazards and Their Prevention (Jan 1, 1991) Construction Safety Engineering Principles (McGraw-Hill Construction Series): Designing and Managing Safer Job Sites Jan 8, 2007) Building Design and Construction Hazards (May 15, 2005)