Marysville firefighter-paramedic Mike Montgomery says the difference between recovery and living life in a nursing home after a stroke is a matter of minutes.

Marysville firefighter-paramedic Mike Montgomery says the difference between recovery and living life in a nursing home after a stroke is a matter of minutes.

"We continued to see a delay in activation of 911. This is why we are trying to get the word out about acting FAST," he said.

FAST is an acronym that stands for:

* Facial droop: Look for asymmetric facial drooping that is new.

* Arms: Is one side of the body weaker than the other?

* Speech: Is the speech slurred?

* Time: If any of these symptoms exist, it's time to call 911.

"Time is critical, as every minute that goes by destroys more neurons," Montgomery said. "This damage cannot be repaired. Hence the need to reduce activation times for EMS."

Marysville Fire Chief Jay Riley put it succinctly: "Time is brain."

Riley said the department annually tracks the number of emergency runs it makes and the reasons for them.

"What we discovered was that in 2011, several of the (stroke) patient families were recorded as stating they delayed calling 911 because they thought something other than a CVA (cerebral vascular accident) was occurring," he said.

Montgomery noted that the incidence of stroke in Marysville is below the national average "but the mortality rate is higher."

According to the American Heart Association, the national average mortality rate of stroke victims was 11 percent in 2011.

Marysville's average mortality rate of stroke victims transported to a hospital by the EMS squad was 36 percent in 2011 and 15 percent in 2012.

The American Heart Association has not released numbers for 2012 national average mortality rate of stroke victims.

Montgomery said the drop in the local mortality rate associated with strokes in 2012 is likely due to better use by EMS squads of the pre-hospital alert process. That is when an EMS provider recognizes when a stroke is occurring and determines to do to best treat that patient.

"After a field screening exam is positive for an active stroke, the paramedic begins treatment and transport to the appropriate facility, and gives them a radio alert of the incoming priority patient," he said. "This heads-up allows the ER staff to clear the needed resources they need at their disposal on patient arrival.

"This process cuts time and therefore saves neurons and improves outcomes."

Information from the Union County Health Department says stroke emerged as the fifth-leading cause of death reported in Union County in both 2010 and 2012.

About 85 percent of all strokes are ischemic strokes, in which blood flow to the brain is blocked by blood clots or fatty deposits called plaque in blood vessel linings.

"Transient ischemic attack (TIA) is a 'warning stroke' or a 'mini-stroke' that results in no lasting damage. Recognizing and treating TIAs immediately can reduce your risk of a major stroke," said Jennifer Thrush, public information officer for the county health department.

Riley and Montgomery said time is crucial in the case of any stroke.

"The big thing is recognizing it. People often put it off or think it's something else or deny the symptoms," Riley said.

Much like a heart attack, he said, a stroke starts to destroy tissue from its onset.

"The damage is not reversible," Riley said. "Time is critical to preserve normal activities. Minutes count.

"When in doubt, contact us and we can help determine if there is a reason to seek emergency treatment. Early recognition is the biggest thing."