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COVID Fears Keep Patients Away from Emergency Care

Orderlies cleaning gurneys in hallway
VCU Environmental Services staff sanitize hospital gurneys. (Photo Courtesy: VCU)

Doctors at VCU Health say have seen a 37% decrease in patients seeking care for stroke symptoms over the past few weeks compared to the same time last year, and are concerned that people who need emergency care are avoiding it because of the pandemic. Charles Fishburne talked with Dr.  Daniel Falcoa, the Interim Director of the VCU Comprehensive Stroke Center about his concerns and what has been done to insure patient safety.


Charles Fishburne: So I guess the real dilemma now is that if a person has a mini-stroke they might be disinclined to go to the emergency room because of the pandemic dangers.

Dr. Daniel Falcoa: That is correct.  So if a patient experiences a mini-stroke, which is called a TIA, a transient ischemic attack, so if you see you, or a loved one experiencing symptoms of face weakness, slurred speech, arm weakness and that symptom is resolved within minutes, that means that the person needs emergency care, because a serious stroke may be soon coming.

Fishburne: Time is so important.  Time is brain.

Dr. Falcoa: Yes, so we know by evidence that every minute we delay treatment, we are looking about two million neurons.  The measurement is based on using a clot-buster which is using a medication called alteplase, and this is also time-dependent.  Or if the patient is eligible, he or she can undergo a catheter-based procedure to have the clot removed.

Fishburne: The clot-buster.  You’ve got a window?

Dr. Falcoa: The window for the use of the alteplase clot-buster is 4.5 hours.

Fishburne: So what assurance can you give people that the emergency rooms are safe and the risk of ignoring some of these symptoms is not worth it?

Dr.  Falcoa: So, I was personally involved with all the steps pertaining to change and adapting the protocol in the context of the COVID pandemic.  And I can assure you that VCU remains safe to all patients.  And our stroke patients here, present in the ED, will be safe and get the best care.

Fishburne: What exactly have you done differently?

Dr. Falcoa: So we have mapped out the whole hospital.  We have…in such a way that we know where the patients who have a diagnosis of COVID or the patients who are now being investigated for possible COVID are.  We also know where the know COVID patient population is also.  And we have also implemented best practices according to guidelines regarding personal protective equipment.  The PPE masks, right?  So the doctors are wearing masks.  We also have patients wearing masks if it is appropriate.  We have also delineated our protocols to have assigned imaging sites, CT scanners, for a specific case.  So one should not be fearful that he or she should be exposed to COVID, just because you come to VCU.

We have been talking with Dr.  Daniel Falcoa, Interim Medical Director of the VCU Comprehensive Stroke Center.  Charles Fishburne, VPM News.

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