Stroke Care

The CHI Health Neurological Institute is a destination clinic for all stroke care needs.


What is a Stroke?

A stroke is to the brain what a heart attack is to the heart. During a stroke, a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot (ischemic) or bursts (hemorrhagic).

When that happens, part of the brain is deprived of oxygen and starts to die. Abilities controlled by that area of the brain are lost temporarily or permanently. In fact, stroke is a leading cause of adult disability in the U.S.

Stroke Risk Assessment

Anybody can have a stroke, but certain factors place you at higher risk. Some factors that increase your risk of stroke cannot be changed. The good news, however, is that many risk factors are linked to lifestyle and are, therefore, under your control. 

Stroke Risk Factors Include:

  • Age (over age 55)
  • Carotid stenosis
  • Cigarette smoking
  • Diabetes
  • Family history of stroke
  • Heart attack
  • High blood pressure
  • High cholesterol
  • Hormone replacement therapy
  • Irregular heart rhythm
  • Obesity
  • Poor diet and inactivity
  • Prior stroke
  • Race (African American)
  • Previous TIA (Transient Ischemic Attack)

CHI Health Primary Stroke Centers

When it comes to stroke, two factors can make a difference in increasing your chance for recovery. The first factor is to act FAST and call 911, because the sooner stroke treatment starts, the better the outcome.

F - stands for Face. An uneven smile or facial droop can both be indicators of a stroke.

A - stands for Arm weakness or numbness. Can the person wave at you?

S - refers to Speech-either slurred or not making any sense.

T - in FAST is Time, which is critical. Call 911 right away if you suspect a stroke.

Or a severe headache with no known cause. 

The second factor affecting outcome is where you are treated. Since 2009, CHI Health has had hospitals that are Joint Commission-designated Primary Stroke Centers. This certification recognizes centers that make exceptional efforts to achieve better outcomes for stroke care. It was developed in collaboration with the American Stroke Association. 

CHI Health Immanuel Hospital's Stroke Patient Outcomes

CHI Health hospitals, clinics and Neurological Institute provide rapid response in the diagnosis and treatment of stroke patients. We continually undertake new research and technology to find the newest state-of-the-art treatments that bring the greatest quality of life to our patients. With our use of a multidisciplinary team, we ensure the best patient care possible.

These CHI Health hospitals are certified as Primary Stroke Centers by the Joint Commission:

  • CHI Health Creighton University Medical Center - Bergan Mercy
  • CHI Health Immanuel
  • CHI Health Lakeside
  • CHI Health Mercy Council Bluffs

Creighton University Medical Center - Bergan Mercy Has Earned AHA's Gold Award for Stroke and Gold Plus Award for Heart Failure

CUMC Bergan Mercy has earned the American Heart Association's Gold Award for Stroke and the Gold Plus Award for Heart Failure. The American Heart Association/American Stroke Association’s Get With the Guidelines program is especially important because it’s been shown to reduce 30-day hospital readmissions and to achieve significant improvements in patient outcomes.

Rapid, Advanced Care

CHI Health Stroke Centers are staffed 24-hours a day by emergency physicians and nurses and other personnel who are specially trained in stroke care and neurologists are always on-call. From the moment the patient enters the emergency room, the coordinated stroke care team performs assessment, imaging, lab and other diagnostics necessary to identify the type and location of the stroke.

Not all hospitals have the necessary staff, equipment and evidence-based procedures in place to diagnose and treat patients with stroke rapidly and efficiently. Our stroke care procedures were developed by a multidisciplinary team, led by physicians and are research-based. They are reviewed and updated annually upon the latest available evidence.

Once a diagnosis is made, a specially trained interventional neurologist may perform a mechanical thrombectomy, which is considered a big game-changer in stroke care. The neurologist threads a catheter through an artery in the patient’s groin to the blocked artery in the brain. A device at the end of the catheter attaches to the clot; the neurologist removes the trapped clot and blood flow to the brain resumes. Brain cells no longer are deprived of oxygen. The neurologist saves the patient from a debilitating – often deadly – "brain attack."

CHI Health’s Interventional Neurologist Vishal Jani, MBBS, is the first neurologist in the state to perform the important emergency procedure.

Other advanced therapies include Tissue Plasminogen Activator (tPA), a clot-busting medication. Early treatment with thrombolytic drugs such as tPA may significantly improve patient outcomes and limit the long-term effects of an ischemic stroke. Neurological, blood pressure, vital signs and visual checks are made at close intervals to monitor medication effects. Oxygen and oxygen monitoring also are started.

After Stroke Care

Following initial treatment, the patient is moved to the Cardiac Care Unit, where an interdisciplinary care team evaluates the patient daily to identify needs, concerns and goals. They are entered into an evidenced-based stroke care plan.

Preventing another stroke or complications from stroke are primary concerns. Blood thinning medications (anticoagulants) are given to prevent clots from forming (deep vein thrombosis). Swallowing difficulty (dysphasia) affects more than 70% of people who have had a stroke. A speech therapist evaluates the patient for problems with swallowing to decrease the chance of food, drink and oral medications from entering the windpipe (aspiration) and causing pneumonia. Bed and chair alarms are installed for patients at risk of falling.

Stroke Rehabilitation

CHI Health Immanuel Rehabilitation Center, offers a Stroke Rehabilitation Program that has earned accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) for meeting the most rigorous guidelines for service and quality. Immanuel Rehabilitation Center offers advanced equipment in a healing environment designed specifically for patients and their families.

Stroke Prevention

CHI Health Clinic primary care physicians educate patients on the signs and symptoms of stroke and the importance of calling 911 when the first signs and symptoms occur. 

Up to 80% of strokes can be prevented in people over age 55 by controlling risk factors such as high blood pressure, high cholesterol, smoking, low physical activity, diabetes and Atrial Fibrillation.

CHI Health Clinic Care Coordinators provide hands-on management of long-term diseases and conditions. CHI Health provides Weight ManagementHeart & Sole walking program and Wellness Centers to promote healthy lifestyles. All programs are directed by certified health professionals.

For people who do not have personal physicians, Health fairs provided by CHI Health enable them to get screened for stroke risk factors and detect potential problems. CHI Health Quick Care provides free blood pressure checks to anyone who requests one.

Continuing Education for Health Professionals

CHI Health sponsors for health professionals a yearly seminar which addresses all aspects of stroke care. Additionally, we offer EMS professionals training in stroke and other topics on a regular basis.

 CHI Health Clinic primary care physicians monitor patients with risk factors and discuss lifestyle changes patients can make to reduce their risk of stroke.