LITTLE ROCK, Ark. (UAMS) – Dustin Martinez's truck crashed through a mailbox, three culverts and hit a tree before he found himself in a hospital as the 500th stroke patient to receive a powerful blood-thinner through the AR SAVES stroke network.
AR SAVES (Arkansas Stroke Assistance through Vital Emergency Support) uses a high-speed video communications system to help provide immediate, life-saving treatments to stroke patients 24 hours a day. The real-time video communication enables a stroke neurologist to evaluate whether emergency room physicians should use the clot busing drug t-PA within the critical 4.5-hour period following the first signs of stroke.
Before Martinez has his stroke on a Monday morning last November, the 29-year-old husband and father of two has experienced a weekend of painful headaches. Martinez, a heavy-equipment operator, was on his way to the Conway construction company where he works. His vision was spotty, and he remembers being confused at a stoplight before realizing it was green and proceeding on through the intersection. Just as he was reaching with his right hand for a cigarette, he believed his hand went numb and limp, falling from the wheel. His memory of the truck he was driving running off the road isn't clear.
Paramedics rushed him first to Conway Regional Medical Center, one of 41 AR SAVES sites at hospitals statewide. Along with his wife, he took part in a medical consultation via a AR SAVES video teleconference with Margaret Tremwel, M.D., at Sparks Regional Health System in Fort Smith. She recommended he receive t-PA and transportation by helicopter to UAMS Medical Center for additional care. In route to UAMS, he received a second dose of the blood thinner.
Before his stroke, Martinez had high blood pressure, which may have been a factor in creating a tear in his carotid artery. A blood clot coming loose from the tear and entering his brain is likely cause of the stroke.
Martinez spent the next four nights at UAMS and by the time he was released he had regained his ability to walk. Although he has some remaining numbness in his left hand, he has no other functional deficits and by Jan. 13 had returned to work.
"I'm sure if this happened again, and I could speak to the paramedics, I'd be telling them to get me to UAMS," Martinez said. "I haven't had a cigarette since that day, I've also changed my diet for the better."
At UAMS, neurologist Archana Hinduja, M.D., and interventional radiologist Eren Erdem, M.D., oversaw his treatment and care.
The AR SAVES program is a partnership between the UAMS Center for Distance Health, the state Department of Human Services, Sparks Regional Health System in Fort Smith and 41 other Arkansas hospitals.
"Although UAMS and AR SAVES have many stories like his, Dustin Martinez's story is a great illustration of a core part of the UAMS mission, reaching out to other areas of the state to improve patient outcomes while helping local physicians identify patients with stroke. The state of Arkansas is amazing in that we can all work together to improve health care for all Arkansans," said Michael Manley, outreach director for the UAMS Center for Distance Health and director of AR SAVES.
Stroke patients are at high risk of death or permanent disability, but certain patients can be helped with t-PA if given within 4.5 hours of the stroke.
Arkansas, which ranks first the nation in stroke death rates, had 1,560 stroke-related deaths in 2011, according to the national Centers for Disease Control and Prevention. Since the program began in Nov. 1, 2008, more than 2,038 patients have received stroke consults through AR SAVES.