Simulation training at NYU Langone helps cut stroke response times

When it comes to treating strokes, time-to-intervention is most critical. About 1.9 million brain cells die on average for each minute that a large vessel stroke goes untreated. To improve recognition of the early warning signs of a stroke, NYU Langone Hospital—Long Island is conducting a quality study with healthcare providers in its Simulation Center in Mineola. During the study, healthcare providers interact with and manage a simulated patient who is experiencing a stroke.

"In our continuing effort to reduce the time when stroke patients first enter our hospital to when they are diagnosed and receive lifesaving treatments, we are utilizing our high-tech Simulation Center to create real-life scenarios to test how quickly responders can recognize the signs of a stroke and act," said Levi D. Dygert, MD, an NYU Langone vascular neurologist who is leading the initiative. "Medical residents and physician assistants are participating in this project, and to date, the results are quite promising."

Patients who are diagnosed with large vessel occlusion strokes typically have two treatment options: receive an injection of clot-dissolving therapeutics, which can be used within the first 4.5 hours, or undergo a neurointerventional procedure to remove the clot by sucking it out through a puncture in the artery.

All members of the stroke team at NYU Langone Hospital—Long Island participated in the training. The most significant finding of the study was a reduction in time from door-to-activation of the neurointerventional radiology team by 12.5 minutes (35.2 percent). The study also found that door-to-arterial puncture time was reduced by 10 minutes (11.9 percent) and door-to-clot removal engagement was reduced by 6.5 minutes (6.2 percent).

"Simulation Center training is always helpful because every case can be different. You are able to get feedback from the medical team that is observing how you reacted to a particular scenario, as well as from actors who may play the roles of patients or their families," said Syeda Fatima, MD, a second-year neurology resident who participated in a training session involving a simulated stroke patient with a complex medical history and an actor playing the role of a family member.

Stroke is the fifth leading cause of death in the United States, and the leading cause of adult disability. On average, every 40 seconds, someone in the U.S. has a stroke. Findings from this study are set to presented to the American Heart Association next year.

The 5,000-square-foot Simulation Center provides valuable clinical training and education for physicians, nurses, residents, and medical students at NYU Grossman Long Island School of Medicine, as well as other health professionals and first responders. The facility provides a safe and engaging educational environment that promotes the knowledge, competence, and performance of the individual learner and the interprofessional care team.