DAVE PARKS
News staff writer

A new system created to get stroke victims quick, brain-saving treatment will start this summer in seven counties in the Birmingham area, organizers said Tuesday.

The system is being formed amid an urgent national call for a medical mobilization against stroke - the third-leading cause of death and leading cause of adult disability in the United States.

''No place in the U.S. is going to have the capacity we have" to respond to strokes, said Joe Acker, director of the Birmingham Regional Emergency Medical Services System.

He said a stroke response system will serve Jefferson, Shelby, St. Clair, Blount, Chilton and Walker counties. It will route people with stroke symptoms to hospitals capable of treating these brain attacks.

''Four, five or six years ago we couldn't do anything for a stroke patient," Acker said. ''Now, we can do the same for stroke patients we can do for cardiac patients."

One of the main drugs used to stem brain damage caused by stroke is ''tPA," which was approved by the U.S. Food and Drug Administration in 1996. But tPA, which dissolves clots blocking blood flow, must be used within three hours of when stroke symptoms begin, medical experts say. Also, strict guidelines must be followed in its administration.

The drug doesn't work for all patients, but there are other procedures that also must be performed quickly to minimize brain damage from stroke, medical experts say.

Eleven hospitals in Jefferson and Shelby counties have committed so far to meeting standards and setting up teams required to treat stroke patients, Acker said. His agency must check each hospital to make sure standards are met before starting the system this summer.

Hospitals in the system are University Hospital, Medical Center East, Princeton Baptist Medical Center, Cooper Green Hospital, St. Vincent's Hospital, Shelby Baptist Medical Center, HealthSouth Medical Center, Montclair Baptist Medical Center, Carraway Methodist Medical Center, Bessemer Carraway Medical Center and Brookwood Medical Center.

Here's how the system will work: Emergency medical technicians dispatched by a 911 operator will evaluate a patient based on levels of consciousness, speech, balance, eyesight and hearing.

If the patient appears to be suffering from a stroke, a trauma communications center will tell EMTs which hospitals have stroke teams on duty. The patient will be transported to a hospital prepared to treat stroke, Acker said.

The goal is to have the patient to a hospital within about 25 minutes, but realistically it will take longer than that from outlying areas, Acker said. Still, the patient will end up at a hospital that has the expertise to provide treatment.

Stroke teams

A key to the system is computer software that will link all the hospital stroke centers. That way, the trauma communications center will know which hospitals have stroke teams on duty.
The system allows a healthy competition among hospitals to meet standards, he said.

''We don't want competition that just drives up health care costs," he said.

Dr. Camilo Gomez, director of the University of Alabama at Birmingham's Comprehensive Stroke Center, said the new system will get stroke patients to hospitals that can care for them.

''We can't take care of all the patients in the state," he said. ''This is not a chest-beating contest."

He said the new system won't be that expensive, and some federal funding has been used to set it up. The result is that Alabama will ''have the only system in the country where all the stroke centers are on line."

Meanwhile on Tuesday, the Journal of the American Medical Association published recommendations for hospitals to create stroke centers, teams and other programs. The recommendations were made by a Brain Attack Coalition representing many top medical organizations in the United States.

A study published in JAMA suggested that many hospitals lack the expertise to quickly diagnose and treat strokes. An accompanying JAMA editorial made an urgent call for better treatment of strokes.