Ambulance Stroke Policy Failing, Putting Elderly Patients At Risk

A spokesperson for Von Essen said that it was the responsibility of Queens hospitals to determine the effectiveness of the stroke program.
Meanwhile, Dr. Thomas Kwiatkowski, chair of the emergency department at Long Island Jewish Hospital, said that hospitals were in no position to keep track of the stroke policy that was implemented by EMS in August of 1999.
That policy mandated that emergency medical technicians radio in vital signs on stroke patients to Queens receiving hospitals so they can prepare for the arrival of stroke patients and alert neurologists and technicians to treat these patients promptly.
Kwiatkowski agreed that the ambulance reform cant be measured unless some group takes responsibility for the policy and the policy was inaugurated by EMS.
The plan was triggered by a series of articles in The Queens Courier after neurologists complained their patients werent receiving priority treatment. That led to a conference of borough legislators including Borough President Claire Shulman, Assemblywoman Nettie Mayersohn and physicians including Kwiatkowski and Dr. Emilio Oribe, director of neurology at New York Hospital Medical Center of Queens.
Shulman wrote Von Essen on August 11, 1999 to "take whatever action necessary to ensure that this matter gets placed on the 911 Committee (the group that sets EMS policy on ambulances) agenda as soon as possible."
She pointed out that Queens seniors were at risk from stroke because the boroughs populations includes the largest numbers of elderly in the city.
The pressure resulted in the implementation of the new EMS ambulance policy.
Another reform sought by Queens legislators and doctors included the establishment of a regional stroke center in Queens that would assure patients skilled care on a 24-hour basis. Kwiatkowski said that discussions have been going on for two years, but no agreement is in sight.
He admitted that Queens hospitals would probably object to designating one center as the borough stroke unit because they fear losing valuable cases.
"We havent even gotten around to that issue yet," he said. "Its too early."
He said the discussions are being held at the American Stroke Association.