When Every Second Counts

How Metropolitan EMS and Baptist Health Medical Center worked together to achieve a remarkable outcome for one stroke patient

When a woman in Little Rock, Arkansas, began showing signs of a severe stroke on her birthday, what followed was a powerful example of how early recognition, coordinated teamwork, and real-time communication can lead to an extraordinary outcome. In this case, the system worked exactly as it should, and the results left even seasoned caregivers impressed.

It All Started With a Fast 911 Call

It was the patient’s 77th birthday. She was getting ready to go out shopping when suddenly, her plans changed. With impaired speech and right-sided weakness, she was experiencing a life-threatening stroke.

Luckily, the patient’s husband remembered learning the BE FAST acronym for stroke symptoms: Balance, Eyes (vision change), Face drooping, Arm weakness, Speech difficulty, Time to act. As soon as he recognized the signs, he made the quick and critical decision to call 911.

That call reached Metropolitan Emergency Medical Services (MEMS), Little Rock’s exclusive EMS provider and key partner to Little Rock Hospitals. Upon arrival, MEMS Paramedics Jim Polatsidis and Marylinda Farnell immediately confirmed the signs of a serious stroke and began preparing for transport.

At the same time, they used Pulsara to send a detailed pre-alert to Baptist Health Medical Center - Little Rock. The stroke team now had nearly 20 minutes of lead time to prepare.

Early Alerts Make a Difference

During a stroke event, treatment time is a critical factor for both the survival and post-treatment wellbeing of the patient. From EMS response through interventional treatment, every minute counts. 

When hospitals do not have enough information prior to a patient’s arrival, assembling necessary resources is far more difficult. Gathering the appropriate care team, beds, rooms, medications, and equipment requires time and accurate patient information. With an early alert and a detailed report, treatment can begin as soon as the patient crosses the threshold. 

That early Pulsara activation from MEMS gave Baptist Health’s stroke team the ability to prepare everything they needed before the patient arrived.

“Because of the pre-alert,” said Kate Caldwell, RN, “the charge nurse was able to notify me of the stroke symptoms, LKW (last known well), and that we would probably TNK (Tenecteplase). I was able to get the room set up, the bed and monitor over to CT before the patient arrived. As the patient rolled in, the entire care team was already ready to go in CT.”

She credits both the EMS team and the patient’s husband for setting the wheels in motion so quickly.

“Somehow, somewhere, the patient's spouse had seen the BE FAST stroke acronym and knew his wife was having a stroke before he was even able to talk to the paramedics. He was his wife’s hero for sure,” Caldwell said.

Faster Treatment Means Better Recovery

Thanks to clear communication from EMS, the hospital team, including the neurologist, nurses, CT technologists, and pharmacy, was fully prepared upon the patient’s arrival. With rapid imaging and clinical evaluation, the stroke was confirmed, and Tenecteplase, a thrombolytic treatment, was administered within two minutes. This extraordinary speed in delivering care reflects a high level of coordination and represents a significant clinical achievement.

Large vessel occlusion (LVO) stroke survivors often face lasting deficits due to brain tissue damage, sometimes for life. The optimal outcome is rapid treatment that leads to complete recovery with no lasting impairments. Thanks to the fast action and coordinated efforts of every caregiver involved, that is exactly what happened in this case. Shortly after receiving TNK, the patient showed dramatic signs of improvement.

“What stands out to me the most when thinking back on this case is the patient outcome,” said Mackenzie Sims, PharmD. “Knowing that this patient was able to leave with no deficits, and truly left our care with the best possible outcome from quick TNK delivery.”

The treatment was so fast and effective, in fact, that the patient’s symptoms were disappearing before the EMS team had left the building.

“It felt pretty great to hear that our patient was awake, talking, and had complete use of her right side again before we even left the hospital,” said Jim Polatsidis, paramedic with MEMS.

With such an impressive treatment time and patient outcome, it’s important to highlight what went right. In this case, the answer is collaboration.

Communication Was Key

For the team at Baptist Health, the early communication enabled by Pulsara was one of the most important factors in the patient’s recovery.

“The early and direct communication we had through Pulsara is what made this case possible,” said Lindsey Bourne, APRN, Stroke Nurse Practitioner at Baptist Health. “The paramedics had the patient’s information, signs and symptoms, essential stroke information, and shared them with us nearly 20 minutes before they were at our door. That made all the difference.”

Polatsidis added that Pulsara has significantly improved the way MEMS teams communicate.

“I’ve found it makes communication with the receiving hospitals more fluid,” he said. “I can go into much more detail than I could with a radio report. With Pulsara, I'm able to pre-alert and give them vitals, last known well, demographics, history, and symptoms before I even get to the ambulance. Then the neuro team/ER can start asking follow-up questions and coordinating with each other on what needs to happen when we get to the hospital. That's exactly what happened with this patient.”

Pictured, from front to back: Row 1: Kate Caldwell, RN; Mary Edgar, RN; Kaitlyn Snowden, Charge RN Row 2: Dr. Eli Johnson, Neurologist; Lindsey Bourne, Stroke APRN; Brittany Thomas, RT (CT); McKenzie Sims, PharmD Row 3: Dr. Patrick Kennedy, Emergency Physician

Flawless Treatment is a Team Effort

The outcome of this case wasn’t the result of one person’s actions, but a full team working in sync. Each person along the patient journey played a key role in providing the rapid treatment they needed. 

“That collaboration is the success here,” said Bourne. “It’s not ‘Look what Baptist did,’ or ‘Look what [MEMS] did.’ It’s ‘Look at what the team does when it works the way it’s supposed to.’”

“Teamwork is what made it possible for this patient to be able to discharge home without residual stroke deficits,” she added.

This sentiment is shared across the board by those involved, including Baptist Health neurologist Dr. Eli Johnson. “Without everyone on the team doing an extremely good job, this would not have been possible. This is a master class in perfect teamwork from a stroke perspective.”

For Kasey Grimmett, RN, Stroke Coordinator at Baptist Health, it all comes back to seamless coordination with Baptist Health's EMS partners.

“It takes a lot of work from the EMS crew—detecting the stroke, providing the pre-alert, getting the patient ready to receive treatment, and then providing all the information to us. I think that’s really what made the difference in this case,” said Grimmett.

Why These Moments Matter

Not every stroke case ends this way, which is why it's so important to celebrate great outcomes when they happen. For many on the team, cases like these are why they do the work.

“This is what makes us push through the hard days,” Bourne said. “Not every stroke is a success story, and when we face hardship, it’s cases like this one that give us the strength to endure and keep coming back.”

For Jim Polatsidis, this case emphasized the importance of his EMS work in the stroke-care timeline. 

“It has definitely opened my eyes a bit more to the significant role we play in the pre-hospital setting, communicating to the hospital what we have and what we are seeing,” he said. “The more time the hospitals are allowed to gather the team, the better chance the patient has at a positive outcome.”

Pictured: Jim Polatsidis and Marylinda Farnell

When Everything Goes Right

From a husband’s quick thinking, to detailed communication from MEMS, to a fully prepared Baptist Health hospital team—this was a case where everything aligned. A patient went from severe stroke symptoms to walking out of the hospital with no deficits, thanks to a system that was connected, responsive, and ready. 

For her birthday, this patient got the gift of people working together, supported by the right tools, when time mattered most.

For more published research and case studies on how Baptist Health Medical Center - Little Rock and other hospitals have seen decreases in treatment times for STEMI, stroke, and trauma, check out Pulsara's Resources page.