Queens Legislators Probe EMS Policy On Stroke Victims

by HOWARD GIRSKY Four independent investigations of EMS (Emergency Medical Service) by borough, state and federal officials were launched last week to find out why City ambulances put stroke patients at risk by assigning a low priority to their care.
The probes were announced last week by Borough President Claire Shulman, Assemblywoman Nettie Mayersohn, State Senator Dan Hevesi and Congressman Joseph Crowley.
They seek answers to growing concerns by Queens citizens––particularly elderly groups vulnerable to stroke –– why these cases are 26th on EMS’ list of ambulance priorities.
EMS is operated by the New York City Fire Dept.
Its medical director, Dr. Lorraine Giordano, last week spoke out in support of EMS’ policy on placing stroke in category four.
"Last November the agency’s medical task force upgraded strokes from category five to four because of the availability of the clot busting drugs," she said. "We feel the position stroke is in is now correct."
She pointed out that some stroke patients do not benefit from treatment with the new drugs.
Giordano said EMS policy in putting cardiac arrest, trauma and heart attacks ahead of strokes is correct
"We’re willing to sit down with Queens neurologists, legislators and others concerned about our stroke policy and to explain it, Giordano said.
The EMS medical director said that educating patients about the symptoms of stroke should be given more attention by the medical community.
Dan Andrews, press secretary to Borough President Claire Shulman, said that Shulman was concerned about the EMS policy and was writing Fire Commissioner Thomas Von Essen to urge him to upgrade EMS’ stroke priority to category one.
"As a registered nurse, the borough president understands the urgency of getting stroke patients into the hospital as quickly as possible," Andrews said.
In her letter to Von Essen, released to The Courier, Shulman called the Fire Commissioner’s attention to the fact that "major advances in the treatment of stroke cases mean it’s imperative to get them into the emergency room more quickly."
She asked Von Essen to explain to her the procedure for reviewing and upgrading this list in order to determine if changes should be considered."
"I urge you to take whatever action is necessary to ensure that this matter gets placed on the 911 Committee’s agenda," she said.
Shulman noted that Queens has the largest aging population in the City and the elderly are at a high risk for stroke.
Mayersohn, meanwhile, announced that she is arranging a meeting next week with officials of the Fire Dept., legislators and private ambulance companies to discuss needed changes in stroke priorities.
Neurologists in Queens said the EMS policy ignores medical advances that now enable emergency room physicians to effectively treat stroke cases with clot-busting drugs such as TPA.