Many of us have a hospital near us that we typically expect to be taken in the event of an emergency. This relationship may stem from our liking the medical staff there, or its location, or a history you may have with that hospital.

But in the case of a stroke, that familiar facility and staff may not be your best bet for survival. And, that is what the Time Critical Diagnosis (TCD) system in Missouri is all about.

If you suffer a stroke in Missouri, the ambulance may not take you to the closest hospital. It will take you to a stroke center designated by the state to have the personnel and equipment to treat this medical emergency.

St. Mary's Medical Center is among only a handful of facilities designated a Level II Stroke Center by the state of Missouri and certified as an Advanced Primary Stroke Center by the Joint Commission. What does that mean? Level II/Primary Stroke Centers offer specialized care to high volumes of patients, from large geographic areas. As such, St. Mary's is equipped to handle all but the most complex cases, which make up only a small percentage of strokes. This designation also helps the few Level I/Comprehensive Centers in our area concentrate on the most difficult cases.

Getting a stroke victim to a stroke center quickly is a critical part of the process. That's why the trip should be made in an ambulance – and not in your family car.

When stroke occurs, time is the enemy. Time lost is brain lost. When you call 911, a number of things begin to happen. Not only is professional response personnel on their way, but the nearest stroke center is alerted to your situation and begins preparing for your arrival, where you can be quickly diagnosed and stabilized – which may allow you to fully recover from the stroke. This simply can't happen if you jump in the car with your loved one to a nearby emergency room.

And yet, many people still try to help shave off time by driving themselves to an ER. Nationally, only 48 percent of stroke victims arrived in hospitals by emergency medical services. At St. Mary's last year, the number of stroke patients arriving via ambulance was only about 40 percent. That practice of self-transportation has led to unnecessary death and debilitation.

Now, a little about stroke, that you can be prepared to act in the event someone you know and love needs that specialized help.

There are two types of stroke: Ischemic and hemorrhagic

• Ischemic stroke occurs as a result of the obstruction of a blood vessel supplying blood to the brain. It accounts for almost 85 percent of all strokes.

• Hemorrhagic stroke occurs when a weakened blood vessel ruptures. Weakened blood vessels can cause hemorrhagic strokes, but the most common cause is uncontrolled hypertension (high blood pressure).

Another condition – TIA – Transient Ischemic Attack is a "mini stroke" that occurs when a blood clot blocks an artery for a short time. The only difference between a stroke and TIA is that with TIA the blockage is transient (temporary). It is more accurately characterized as a “warning stroke,” a warning you should take very seriously.

Spotting a stroke is something you can actually do, if you think F.A.S.T.

• F – Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?

• A – Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

• S – Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?

• T – Time to call 911 – If someone shows any of these symptoms, even if the symptoms go away, call 911 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.

Know the symptoms; call 911. Time is brain!

You can reach St. Mary’s Stroke Center at 816-655-5563.