Intro: Riverside Healthcare, puts the health and wellness information you need well within reach.

Terry Streetman (Host): Welcome back to Well Within Reach. I'm Terry Streetman, Riverside Marketing Communications representative. We're here today with Drew Ogrentz, Clinical Manager in the Riverside Emergency Department. We're going to discuss how we treat strokes here at Riverside, how that treatment has changed or will be changing with the addition of new technology. Thanks so much for joining us, Drew.

Drew Ogrentz: Yeah, Terry. Thanks for having me today. 

Host: So before we get into our questions though, we're going to take a quick break for a message about myChart.

MyChart ad: Healthcare can be confusing, but thanks to your myRiverside myChart, you can easily manage not only your care, but your family's as well. With a single click, your myRiverside myChart lets you stay well connected to the same information your provider sees. You can view your health history, get test results, request prescription refills, pay your bill or make an appointment. Manage your care from anywhere, your laptop, phone, or tablet. Learn more and enroll today at riversidemychart.org. 

Host: We're back. Welcome, Drew. Thank you so much for joining us again. This is your first time here with us on the podcast. So, could you tell us about your background and your role here at Riverside? 

Drew Ogrentz: Yeah. So, I was born and raised here in the community. I was actually born at Riverside. Me and my wife live here in the community with our two daughters. They keep us very busy. I started at Riverside in 2018, was a floor nurse, kind of worked my way up. My current position now is I'm the clinical manager of the ER. So, I'm in charge of the day-to-day operations of the ER and making sure we're meeting all of our quality standards.

Host: Awesome. Well, that's a great story. You start out here and then continue here. We love to see that. That's that community hospital approach. So, can you talk about then-- you've seen some of this, we've made some big changes and improvements to the emergency room, the emergency department over the last few years.

Drew Ogrentz: Yeah. If anybody was in our old ER, it was time for a facelift. In 2021, we started a large project right after COVID to remodel the entire ER. And for those that don't know, you can't just completely shut down your ER. So we were actually working out of a split ER. We say thank you to everybody for the patience that they showed. I know it was some testing times, but the new space is great. We have great technology now. We're able to use all the technology to the best of its ability. We have private rooms for every patient, and the spaces are just much better for giving treatment to patients.

Host: Awesome. Well, yeah, we love to be able to have that comfort and that feeling of safety for folks, because you don't come to the ER on a good day. We're glad we can provide them with that. Specifically here, we're going to talk about stroke. So, let's start off with the basics. We have an acronym that we use, to remember the signs of stroke. Can you remind us? That acronym is BEFAST? What do those letters stand for?

Drew Ogrentz: So yeah, BEFAST is the acronym we use to quickly identify if somebody's having a stroke. So. B, first of all is for balance. If you notice somebody losing their balance-- and these are all symptoms that come out of nowhere, they'll be fine one minute, and then they'll be having these symptoms the next. So, B is for balance, sudden loss of balance. Eyes, you'll notice that they'll complain of their vision changing or blurred vision. F is face, they'll have the droop, that's the clinical normal presentation you'll see kind of on TV. They'll have that droop on that side of the face. Arm weakness. So if you have 'em hold their arms up and one arm drops, that is a clinical sign, and it'd be on one side. And then, speech. So, people will say they almost sound drunk. They're slurring their speech. That would be a big clinical sign. So, time is the last part of the BEFAST. We need to know in the hospital when the last time they were normal. That's a question a lot the paramedics are going to ask when they get on scene, because that tells us how quickly we need to treat what's going on.

Host: Okay. Yeah. That timeliness, I know is one of the most important things. So, in the interest of that then, people notice these signs, they call 911, as quickly as possible. What is that process then once you call 911 for that person who is going through that?

Drew Ogrentz: Yeah. So, patients having any of these symptoms should immediately seek treatment. Time is brain. And the quicker you can get the patient to us, the quicker we can start that treatment. We can treat strokes up to 24 hours. So if you go to bed and you're perfectly normal and you wake up and you're having these symptoms, we still want you to come in and get assessed. Even if you're outside that 24 hours, you should still see a provider.

So when you get to the ER, the ambulance will have already called us. We will alert our stroke team. We'll call a code stroke. They'll be brought in. That gets the whole team ready. When you walk through those doors at the ER, the doctor's going to meet you at the door. They're going to assess you. They're going to do another check just to make sure your airway is patent. And then, you're going to go immediately to our CT scan.

Our CT scan is connected to our ER. So, it lets us get you over there quickly. We'll do a quick scan of your brain. You'll be brought back to the ER. We actually work with Rush Medical Center in Chicago. They're our neurologist partners. We have the technology. We have a robot in our ER. It allows us to almost like FaceTime, they're able to FaceTime. They're able to do a quick assessment and we can see where that stroke is coming from. If it's deemed that you can, you're in a four-hour window, that's the time we really try to narrow that down to, we could give you a medication called tenecteplase. It's a clot-buster. It's TNK for short. And it has its risk, but it has great positive benefits too, if we can get that to you in a timely manner.

Host: Okay. Yeah. Well, one of the things that really stands out to me there is that team approach. We've got the emergency department, we've got the CT, we've got the imaging, we've got the neuro folks and that team, those partners at Rush, which I'm sure is a big help for making sure people get that treatment.

Drew Ogrentz: Definitely.

Host: All right. So, you've kind of touched on what that process is for us, but what is it that makes Riverside stroke treatment special, and why should folks, if they're calling 911, ask, "Hey, I want to go to Riverside's Emergency Room?

Drew Ogrentz: Yeah. Riverside is a nationally recognized from DMV as a primary stroke center. As I said earlier, we've made large investments in our ER. We have that technology. One investment we actually made was in everybody's moving to AI. We actually purchased an AI system called Viz.Ai. It allows us to instantly read your CT scan. So back in the day, your imaging would have to go to a radiologist, have to be read. Those are read first, but it still takes time for a human to read those images. With this AI system, now we can get those results instantly. So by the time you're back from CT, the doctor kind of already has a plan of what they're going to do. Like we keep saying, time is brain. So, if we can narrow that timeframe up as much as possible, that helps us treat the patient.

Host: Awesome. And specifically then, I know we've had some developments and we're working on some developments for stroke care. Can you talk about the new equipment, the new techniques that we're working on for that?

Drew Ogrentz: Yeah. In the near future, so we actually developed our neurointerventional suite. So, we have a biplane angiograph system now, so that allows for 3D imaging for our neurologist. Dr. Zakaria was actually specialized trained in this area. He can go in and pull those clots if you're having a specific type of stroke, actually out of the brain. So, you know, it has to be the certain size, it has to be in a certain area, but that just gives us the ability to treat those type of strokes in a different way than we were treating before.  

Host: Wow. Okay. Well, that's a pretty big investment and I think pretty important to have that here locally. We'll have some more questions, but before our next one, we'll take a moment to talk about the importance of primary care.

Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive. Find the right primary care provider for you at my rhc.net/acceptingnew. From annual screenings to well-checks and everything in between, having a primary care provider that you can trust makes all the difference.

Okay. So, we're back. We've touched on this new technology, these new techniques, how has this changed that process then of a patient going from the emergency room through treatment or how will it? 

Drew Ogrentz: Yeah. So with the new biplane that we're able to do, these patients in the past would have to go to a larger tertiary center. With our Rush partners, we would transfer them to rush. Now with this specific type of plot, we're able to do that care here at Riverside. When you're having these serious things, you don't want to leave your community. You want to be around your family. We don't want to have to send you up to Rush. And like we say, time is brain. If the weather's good, that's a helicopter ride to Chicago. That's the fastest way we can get you there. But that time is a lot shorter if we can just roll you over to our interventional suite and perform that procedure here at Riverside.

Host: Awesome. Well, I'm sure that helps to keep people close to home. So in addition to stroke then with this new technology, these new techniques coming online, are there other conditions that we can address with that as well beyond stroke?  

Drew Ogrentz: The main one, it's called an LVO. It's a large vessel occlusion. That's the main thing we're able to treat in this area. Those are the larger vessels in your brain that we're actually able to go in and take those clots out to free up and let blood get to that part of the brain. The other thing Dr. Zakarias trained in is treating hemorrhages. So, he can actually go in and clip aneurysms if they're leaking or bleeding before they get worse. And sometimes aneurysms do burst, and that can be really detrimental to the patient. So, we're actually able to go in there and fix that before it gets to that point.

Host: That is wild. That's very cool that we can do that here. So, what would you say then we're getting towards the end here? If somebody was listening to this, what would you want their biggest takeaway to be from what you've said here today?

Drew Ogrentz: So, I think the biggest takeaway is just to be able to recognize the symptoms. If your loved one is having stroke symptoms and being able to know the resources in the community that they can go to, Riverside's a really kind of a one-stop shop in this area. Because, unfortunately, with a stroke you do have rehab after. So, at Riverside, you can come to the emergency room, we can do those procedures, you can get your care at Riverside, and then you can also rehab at Riverside after your stroke. So, those resources are available in your community. You don't have to go to Chicago to get those services.

Host: That's awesome. And that's that team approach again, having the system here behind you to help you with that whole process, that continuum. Well, that's great. I've only got one question left. I'm just going to ask if there's anything else you'd like to add.

Drew Ogrentz: Yeah, I did just want to give a shout out to the ER, my team back in the ER, they're doing a great job. I think over the last five quarters, we've actually been in the 90th percentile for patient satisfaction. And I think that just goes to show the great care they're giving and the great care that our patients are feeling here at Riverside.

Host: Oh, that's awesome. We love our emergency room team. We really appreciate you. And yeah, you guys do great work over there. So, thank you for everything you do. Well, thank you again for joining us today. We really appreciate everything you've shared.

Drew Ogrentz: Thanks.

Host: If people are interested in learning more about Riverside's Emergency Care, you can visit my rhc.net/emergency. And if you want to learn more about our area leading stroke treatment capabilities, visit my rhc.net/strokecare. Thank you for tuning into Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for Well Within Reach on Apple, Spotify, or wherever you get your podcasts. And to learn more about Riverside, visit riversidehealthcare.org.