The American Heart Association is pumping $5 million into a program to bolster stroke care in Wyoming. Recognition of early symptoms and quick access to care are two goals of Mission: Lifeline Stroke. Wyoming Public Radio's Nicky Ouellet talked to a few people bringing the program to the Equality State.
Melodie Edwards: Nicky, what's this program aiming to do?
Nicky: The end goal is to reduce the amount of time it takes for a patient to start receiving care when they're having a stroke. So that means getting everyone from ERs and hospital staff to EMTs and ambulances, rehabilitation providers, public health, community organizations, and even the public – it's getting them all on the same page about how to quickly identify and treat a stroke.
I talked to Walter Panzirer with the Helmsley Charitable Trust, which is giving the lion's share of this $5.2 million award, and he worked as a first responder in rural South Dakota. He said when it comes to a stroke, “time is brain."
Walter Panzirer: One-point-nine million neurons die every minute when blood flow is disrupted in the brain. And once those neurons die, they don't come back. And so time is of the element. In rural America, time is a challenge because of the distances. Getting people to recognize symptoms of a stroke early on, ambulances being dispatched out there, and then it's also a challenge on which hospitals to bring it to because not every hospital is a stroke-ready hospital, and that's what this grant is going to help change.
NO: Stroke is the fifth leading cause of death in Wyoming. In 2024, 238 people died of a stroke in that year, and it's also a leading cause of disability
ME: Let's talk nuts and bolts.
NO: This funding will support 28 hospitals in the state to strengthen evidence-based care. Nancy Brown, the CEO of the American Heart Association, which is the umbrella organization for the American Stroke Association, told me that they want to strengthen coordination and improve the quality of care to support better outcomes
Nancy Brown: From the moment the patient hits an emergency room, or if they're in a very remote area and we're using telemedicine to dial into an emergency room, what are the best practices of how that care can and should be delivered? And the best thing about creating a system of care is these hospitals can learn from each other. Every hospital is unique in their own way, but there's a lot of similarities in delivering clinical care. And so we try to create a system where people can share and learn from each other as well.
ME: Is the American Heart Association only focusing on Wyoming?
NO: No, Mission: Lifeline Stroke has been active in a bunch of states over the past several years. The American Stroke Association released guidelines about a decade ago to help hospitals, particularly in rural areas.
Nancy Brown: We have 143 hospitals in seven states that serve more rural populations that are enrolled in the Get With The Guidelines – Stroke registry that allows us to give real-time decision support to doctors. That helps us do things like lessen the time from symptom recognition to hospital transfer, that we're able to make sure that the EMS systems are coordinated and people are taken to the hospital that can best treat their chance of recovery. And that's what we have seen in our work in guiding all of these post-acute facilities to make sure that these stroke standards are followed.
NO: This program is coming to Wyoming at the same time that the state is awarding its first year of federal Rural Health Transformation Program funds. And while these are completely separate programs, Nancy said they're going to be complementary efforts.
Nancy Brown: The Rural Health Transformation Program in Wyoming is providing investment for things like workforce and technology and infrastructure for EMS, while what we're doing with Mission: Lifeline Stroke is creating a system of care initiative that provides the quality framework and this expertise to improve the coordination among all of the players, and then we can help measure performance and advance care.
NO: Something that both Nancy and Walter stressed to me is that time is of the essence, and a lot of that falls on family and loved ones, or even somebody who sees you at the coffee shop, recognizing if you're having a stroke and then calling 911 immediately. Walter talked about how rural Westerners are tough. They don't wanna ask for help. But like he said, every minute an intervention like a thrombolytic is delayed is more brain cells lost.
WP: We want to convince all people to remember that you need to call 911. You don't need to tough it out and go drive yourself to the hospital, because there's interventions that can be done on the ambulance. [It’s] also important for the hospital to know a stroke patient's coming, so that way they're ready and can give the highest quality care in the fastest amount of time.
NO: And to the point of recognizing stroke symptoms, Nancy had a handy mnemonic device.
ME: Like one of those acronyms like ROY-G-BIV for the rainbow.
NO: Exactly. For strokes, it's “BE FAST.”
Nancy Brown: BE FAST, which is around the stroke warning signs. B is for balance loss. E is for vision changes or eye changes. F is for face drooping. A is for arm weakness. S is for speech difficulty. And T is for time to call 911.
