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EMS Systems Division - Specialty Care

About Specialty Care

Specialty Care includes Poison Control (see below), Stroke (see below), STEMI (see below), Trauma care (found here), and EMS for Children (found here).

California Poison Control System

California Poison Control Information

For Questions Contact:

Teri Harness
Assistant Division Chief
teri.harness@emsa.ca.gov 
(916) 322-4336, Extension 462

About Stroke

Stroke Definition

A stroke happens when blood flow to a part of the brain is interrupted because of a blood vessel in the brain is blocked or bursts open. The sudden death of some brain cells due to a lack of oxygen when the blood flow to the brain is impaired by blockage (Ischemic) or rupture (Hemorrhagic) of an artery to the brain. Stroke is also called a cerebrovascular accident or, for short, a CVA. Ischemic strokes are caused by the blockage of a blood vessel and hemorrhagic strokes are caused by bleeding in the brain. The American Heart Association (AHA)/American Stroke Association (ASA) describe the ischemic stroke as “the most common type and accounts for about 87 percent of all strokes”.

The most common symptom is weakness or paralysis of one side of the body with partial or complete loss of voluntary movement or sensation in a leg or arm. There can be speech problems and weak face muscles, causing drooling. Numbness or tingling is very common too. A stroke involving the base of the brain can affect balance, vision, and swallowing, breathing and even unconsciousness.

A stroke is a medical emergency. Anyone suspected of having a stroke should call 911. By calling 911 ensures that care begins immediately and person transfers to the most appropriate medical facility for diagnosis and treatment.

The AHA/ASA and the Joint Commission describe studies that show better outcomes when strokes are approached as a systematic plan. Early use of anticoagulants to minimize blood clotting has value in some patients. Treatment of blood pressure that is too high or too low may be necessary. Control of any primary disease like Diabetes, might be helpful.

Local STEMI/Stroke Systems

Some local EMS agencies (LEMSA), which may include one or more counties, have developed STEMI and/or Stroke Care Systems. The systems vary from LEMSA to LEMSA. The AHA/ASA is conducting a detailed survey on STEMI and Stroke system approaches. To date the EMS Authority has identified the following LEMSAs as developing/implementing an approach to STEMI and/or Stroke Care: Alameda, Central California, Coastal Valleys, Contra Costa, Inland Counties, Los Angeles, Marin, Merced, NorCal, Orange, Riverside, Sacramento, San Diego, San Francisco, San Mateo, Santa Barbara, Santa Clara, and Ventura EMS.

EMSA Participation in Stroke Work Groups

EMSA staffs are members of the Stroke Work Group co-convened by the ASA and California Department of Public Health Stroke Prevention Program. The work group is discussing ways in which to improve stroke outcomes statewide.

For Questions Contact:

Farid Nasr, MD
Specialty Care System Specialist
Stroke & STEMI (Cardiac)
farid.nasr@emsa.ca.gov
(916) 322-4336 Ext. 424

About STEMI (Heart Attack)

STEMI Definition

An electrical cardiogram (EKG) graphically represents the electrical activity of the heart through electrical impulses forming P, Q, R, S, and T waves. When the wave forms are joined the combined forms are referred to as segments. One of the segments on the EKG is the ST segment which corresponds to the heart repolarizing (electrical recharging). When ST segments fail to repolarize the EKG shows an elevation in the ST segment. One type of heart attack or acute Myocardial Infarction (MI) is recognized when two of twelve ST segments on the 12-lead EKG elevate. Upon recognition of a ST elevation MI (aka STEMI), EMS providers, hospitals, and EMS systems may develop processes to achieve optimal care. Optimal care involves the America Heart Association/American Stroke Association (AHA/ASA) guidelines outlined in Advanced Cardiac Life Support (ACLS) 2007 which includes an algorithmic process leading to thrombolytic administration (clot buster), percutaneous intervention (stent placement) with a cardiac catheterization laboratory (cath lab), or coronary artery bypass surgery (open heart surgery).

Local STEMI/Stroke Systems

Some local EMS agencies (LEMSA), which may include one or more counties, have developed STEMI and/or Stroke Care Systems. The systems vary from LEMSA to LEMSA. The AHA/ASA is conducting a detailed survey on STEMI and Stroke system approaches. To date the EMS Authority has identified the following LEMSAs as developing/implementing an approach to STEMI and/or Stroke Care: Alameda, Central California, Coastal Valleys, Contra Costa, Inland Counties, Los Angeles, Marin, Merced, NorCal, Orange, Riverside, Sacramento, San Diego, San Francisco, San Mateo, Santa Barbara, Santa Clara, and Ventura EMS.

EMSA Participation in STEMI Work Groups

EMSA staff are members of the STEMI Work Group co-convened by the AHA and California Department of Public Health Stroke Prevention Program. The work group is developing guidelines for the Early Management of Adults with ST-segment Elevation Myocardial Infarction: A Statewide Plan for California.

For Questions Contact:

Farid Nasr, MD
Specialty Care System Specialist
Stroke & STEMI (Cardiac)
farid.nasr@emsa.ca.gov
(916) 322-4336 Ext. 424

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