PINEHURST, N.C. – It was a normal Tuesday morning – until it wasn’t. Dale Krech was working at his home computer around 9 a.m. on March 25 when he began to feel odd.
“My eyes were not working right, and I was having trouble moving,” he recalled.
Krech recognized right away that he might be having a stroke. He knew immediately that time was critical and got himself to Moore Regional Hospital emergency department, arriving at 9:14 a.m.
“The registration staff at the emergency department immediately informed the triage nurse of my symptoms, and my care was off and running within a couple of minutes,” he said.
Matthew Vreeland, M.D., an emergency medicine physician at FirstHealth, arrived at Krech’s side at 9:18 a.m. and quickly activated Moore Regional’s stroke line, which alerts additional specialists who can care for patients. The stroke alert orders were entered, including an emergent CT scan.
Neurohospitalist Amanda Dow, D.O., had her first contact with Krech at 9:24 a.m. She observed that Krech had slurred speech, blurred vision and loss of coordination. After his CT scan was completed, Krech received a clot-busting drug called tenecteplase at 9:49 a.m., only 35 minutes after he had walked in the door of the emergency room. He was transferred to Moore Regional’s MedNeuro ICU department for close monitoring.
Melanie Blacker, M.D., stroke program director for FirstHealth, said Krech’s care is “the model” for how the system aims to treat strokes.
“The American Heart Association sets goals for our ‘door to needle’ time, or essentially how long it takes us to deliver a clot-busting drug to someone having a stroke,” Blacker said.
“In Dale’s case, treatment was provided within this goal, thanks in part to Dale’s quick thinking and the outstanding work of everyone involved in his care, from the registration staff to Drs. Vreeland and Dow and even our imaging staff who worked quickly to complete a CT.”
For Krech, what began as a scary morning of uncertainty had turned around quickly.
“I really did start feeling better within an hour, and I went home the next afternoon,” he said. “That’s pretty remarkable.”
Early treatment of stroke doesn’t just save lives—it also improves quality of life. Prompt medical intervention can limit the extent of brain injury, increase the odds of full or partial recovery, and reduce the need for long-term rehabilitation.
Krech is among the thousands of people in the United States who have a stroke each year. About 800,000 people experience a stroke annually in America, and it is the fifth leading cause of death.
There are two main types of strokes: ischemic and hemorrhagic. Ischemic strokes, caused by a blockage in an artery supplying blood to the brain, account for about 87% of all strokes. Hemorrhagic strokes, which result from bleeding in the brain, are less common but often more deadly.
Stroke risk factors include high blood pressure, diabetes, smoking, obesity, and high cholesterol. Importantly, many of these risks are preventable through lifestyle changes and medical management.
Stroke Care at FirstHealth
As a primary stroke center, Moore Regional offers advanced stroke care, including:
- A full-time neurohospitalist team
- A 24-bed dedicated neuro ICU
- Inpatient rehabilitation
- Neurosurgery services
FirstHealth’s acute stroke ready certified hospitals in Hoke, Montgomery and Richmond counties also recently launched a new “Stroke Alert Pit Crew” initiative — a high-speed, high-coordination response process modeled after NASCAR pit crews — to accelerate the care of patients experiencing stroke symptoms.
This initiative ensures that each hospital is capable of triaging for stroke, administering clot busting medication and performing advanced neuroimaging to determine whether the patient needs rapid transfer to a primary stroke center, such as Moore Regional Hospital in Pinehurst, for critical stroke monitoring and care or to a comprehensive stroke center for emergent clot retrieval.
Recognize the Signs of Stroke: BE FAST
Everyone plays a role in stroke survival, and recognizing the symptoms can save lives. Use the acronym BE FAST to spot warning signs:
- Balance: Sudden loss of balance or coordination
- Eyes: Sudden blurry or loss of vision in one or both eyes
- Face: Sudden numbness, one side drooping—can you smile?
- Arms: Sudden weakness or numbness in arms—can you raise both arms?
- Speech: Slurred or mumbling speech
- Time: Call 911 immediately—time is brain
For more information about stroke care at FirstHealth or how to recognize stroke symptoms, visit www.firsthealth.org/stroke.
