A man suffering a stroke collapses in his shower. He only has a few hours before irreversible damage occurs in his brain.
This is a situation Humber College professor and part-time Peel Region paramedic Richard Alvarez remembers quite vividly. That’s because he was able to help save the man’s life.
“He was found on the bathroom floor,” said Alvarez. “It was pretty clear cut with the symptoms he was displaying that he was indeed having a stroke.”
Hours after Alvarez transported the patient to Trillium Hospital in Mississauga, he returned there on another call. He found the man in bed, talking to his family. They confirmed that he had had a stroke.
“He was fully functional. No deficits,” said Alvarez. “It was one of those moments where everything in the system worked the way it was supposed to.”
Alvarez said there is a time frame from a few minutes to a few hours from the onset of symptoms when stroke drugs need to be administered in order to be effective.
“Missing that window can be frustrating,” he said.
Canadian medical research company, Rescu, launched a drug trail on Tuesday called Frontier where paramedics in Toronto, Vancouver, Richmond and the Region of Peel will be using a drug called NA-1 to treat eligible stroke victims in the ambulance.
The trial will run for up to two years, said Laurie Morrison, a scientist from the Keenan Research Centre in Toronto.
Prior to this trial, it has been a matter of beating the clock, says Humber Paramedics student Nick Tersigni.
“There has not been much you can do for (stroke victims) except move quickly, transport quickly and take them where they need to be,” Tersigni said.
NA-1 is an emergency drug aimed at preventing disability in stroke victims. The drug is designed to be administered within three hours from the point when symptoms begin to show.
According to Rescu, the drug will be initially administered without consent in ambulance, and then the family of the victim will be asked if they would like to continue with the trial, once the situation has been stabilized.
“We like to give it early so that it has the greatest chance of showing an impact on saving brain cells,” said Morrison. “That’s why we are trialing it in the ambulance.”
Caring for the patient is paramount, said Morrison. In trails that deal with life-threatening situations it is not possible to obtain consent without compromising the patient’s access to urgent medical care, she said.
Previous stroke drug trials were performed by neurologists very late in the process, often four to six hours from symptom onset, said Morrison.
“We think some of these drugs may have been effective, but they were just given too late,” she said. “By then, there’s not much brain left to save.”
Alvarez says that the early results of NA-1 are positive and the drug is looking very promising.
“I’ve heard that this is the new penicillin or the new insulin of the 21st century,” Alvarez said. “It’s going to be a breakthrough and if it does what it’s supposed to do, I can’t even imagine how big this will be internationally.”
Alvarez said he keeps his students up-to-date with the latest medical innovations and technology. Humber students will be trained on the administration of NA-1, he said.
“What I think is most beneficial about the drug is that it opens up the door for the paramedic field in the future,” said Tersigni.
“Because of the way (NA-1) is administered, it requires paramedics to basically improve their scope of practice.”
Morrison said she can’t leapfrog the findings to declare what this trial means for the future of stroke victims, but she has hope.
“If we do the trial correctly and we find a significant impact, then the potential to help so many patients is so big,” she said.