Stroke Care

To better serve our community, Onslow Memorial Hospital has made stroke care and education a top priority with the hospital and community. Since 2008, we have participated in a wide variety of community events and health fairs. If you have any questions and/or are interested in having stroke education or screening brought to your organization or health fair, please feel free to contact our Stroke Nurse Coordinator at (910) 577-2838 or by email at

In 2023 OMH was awarded the American Heart Association Get With The Guidelines - Heart Failure GOLD with Honor Roll and Target: Type 2 Diabetes Honor Roll, as well as the Stroke GOLD PLUS with Target: Type 2 Diabetes Honor Roll. These awards are a testament to our commitment to treating stroke patients with the highest levels of care outlined by the American Heart Association/American Stroke Association.

The hospital also achieved The Joint Commission’s Gold Seal of Approval as a Primary Stroke Certification in June 2012 and was recertified in 2014, 2016, and 2018. We were the second hospital east of I-95 to receive this distinction.

Our passion to providing excellent stroke care and education to our patients and community will continue. Stroke is the fifth leading cause of death in the United States today and the fourth leading cause of death in North Carolina. Research suggests that delays in seeking treatment for stroke symptoms limits effective treatment options and results in a greater likelihood of permanent disability or death. Onslow County is considered to be the Nation’s Stroke Belt Buckle, an area where stroke mortality is two times higher than the national average. It is important to take steps to prevent and control stroke risk factors. The health of our community affects everyone.

DSC Primary Stroke logo 2019


The longer blood flow is cut off to the brain, the greater the damage. Every second counts. The most common kind of stroke: ischemic stroke can be treated with a drug that dissolves clots blocking the blood flow. The window of opportunity to treat stroke patients with this medication is four and a half hours. Depending on where the clot is in the brain, mechanical removal may be considered for up to 24 hours after symptoms start.

It’s critically important to know the warning signs of stroke. If you act quickly and seek treatment immediately, you could reduce the disabilities caused by stroke. Call 911 immediately if you or someone you know experiences these signs of stroke:

  • Sudden weakness or numbness that occurs in the face, arm or leg, particularly on one side of the body
  • Sudden difficulty seeing in one or both eyes
  • Sudden confusion, difficulty speaking or difficulty understanding - may have slurred speech or confused speech
  • Sudden problems with walking; dizziness; a loss of balance or coordination
  • Sudden severe headache, the cause of which is unknown
  • Difficulty swallowing

It is important to understand the factors that can increase your risk for stroke. Although some risk factors for stroke are uncontrollable, research has shown that you can take steps to prevent stroke by reducing and controlling certain risk factors.

Lifestyle Risk Factors:

  • Poor diet and nutrition – working to improve your diet will help reduce your risk of obesity, high cholesterol, high blood pressure and diabetes
  • Lack of physical activity – regular exercise can improve your overall health and fitness
  • Cigarette smoking or exposure to secondhand smoke – smoking doubles the risk of stroke
  • Alcohol – alcohol use has been linked to increased blood pressure and risk of stroke
  • Use of illegal drugs, especially cocaine and methamphetamines

If these lifestyle risk factors are addressed, then your medical risk factors will also lessen.

Medical Risk Factors:

  • High blood pressure – risk of stroke begins to increase at blood pressure readings higher than 115/75 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
  • High cholesterol – a total cholesterol level above 200 milligrams per deciliter
  • Atrial fibrillation
  • Diabetes
  • Circulation problems
  • Coronary artery disease

Uncontrollable Risk Factors:

  • Age – as we age our risk for stroke increases, although many young people have undiagnosed hypertension so everyone should have routine screenings
  • Gender – women experience more strokes each year than men
  • Race/Ethnicity – African Americans have twice the risk of stroke, Hispanics and Asian/Pacific Islanders also have a higher risk than Caucasians
  • Personal or family history of stroke, heart attack or TIA (Transient Ischemic Attack) sometimes known as a mini-stroke

Click here to hear an interview with NCSA Program Coordinator Margaret Rudisill along with Jo Malfitano of Onslow Memorial Hospital, an NCSA partner hospital, and other health professionals as they discuss the incidence of stroke in North Carolina, paths to prevention and advances in treatment options.


Q&A with Stroke Nurse Coordinator

A: Onslow County is considered to be on the belt buckle of the United States’ Stroke Belt. The Stroke Belt is an area with high rates of hypertension, cardiovascular disease, obesity, and diabetes – factors that put this population at significant risk for stroke. The highest hospitalization and death rates of stroke patients are in the coastal region of North Carolina, which includes Onslow County.

Stroke is the leading cause of disability, the fourth leading cause of death in the United States, and the fourth leading cause of death in North Carolina. In 2008, there were 4,477 deaths in North Carolina caused by stroke, which was 5.8% of all deaths in that year. The deaths of stroke patients under the age of 65 account for 14.7% of all stroke deaths in North Carolina. Stroke does not just affect the elderly. There is no age that is safe from stroke. However, the risk of death caused by a stroke does increase with age.

A: Stay healthy and active in life. Make sure to participate in daily physical exercise, whether it is taking a walk or working out in a gym. Be sure to eat healthy. Follow a heart-healthy diet by controlling your portion sizes, eating more vegetables and fruits, selecting whole grains, and limiting unhealthy fats and cholesterol. Be sure to see your primary care physician on a regular basis.

A: While a patient at Onslow Memorial Hospital, the hospital ensures that stroke/TIA patients receive an education packet on admission, as well as daily education by a variety of staff members throughout their hospital stay. There are also videos on demand, which can be viewed on each patient’s television, that provide education about preventing strokes and living with the after effects of a stroke. Our goal is to provide our patients with a solid knowledge base of signs and symptoms of a stroke, and to emphasize the importance of calling 911 at the onset of any of these symptoms; following up with a primary care provider; not using tobacco, alcohol or drugs; receiving rehabilitation services; and being knowledgeable and compliant with regard to medication.

OMH participates in many community events. The goal of these events is to get as much information to the general public as possible. This is done by offering educational materials, discussion, and free stroke risk screenings (blood pressure, glucose and cholesterol checks). Prevention is the first step in stroke education. Stroke risk factors include heart disease, smoking, high blood pressure, diabetes, high cholesterol, unhealthy eating, obesity, lack of physical activity, and heavy alcohol use. The citizens of Onslow County can promote their own health and prevent disease and illness by taking steps to prevent and control stroke risk factors. It’s important to recognize the symptoms, “B.E. F.A.S.T.”, and call 911.

A: Previously, Vidant Medical Center was the only facility east of Interstate 95 that had this distinction. Obtaining this accreditation reinforces our plan of care and protocols currently in place to provide the needed care for stroke/TIA patients. It acknowledges that OMH’s staff is committed to maintaining a high level of compliance with The Joint Commission’s standards for stroke care. This accreditation could not have been accomplished without the staff’s previous hard work and continued work providing exceptional care to our stroke/TIA patient population.

A: A stroke nurse coordinator can have many different responsibilities. These responsibilities differ from facility to facility.

At Onslow, my responsibilities are vast. I regularly visit hospital patients who were admitted with a diagnosis of stroke or TIA (transient ischemic attack, often called a “mini-stroke”). I review their charts to ensure that each patient’s care meets The Joint Commission’s standard of care for stroke/TIA patients. If the opportunity for improvement is found, I educate the staff/physicians that have been involved in the care of the patients. My goal is to prevent any missed opportunities for the exceptional care of our stroke/TIA population. In addition to these tasks, I also facilitate the Stroke Team meetings.

Community involvement is a key to stroke education and awareness. Therefore, I participate in community events by providing educational materials, discussion, and even free cholesterol and glucose screenings. This is vital to ensuring the education of our community. These events are hosted throughout the year by various churches, civic organizations, community groups, etc. Here at Onslow Memorial Hospital we are constantly looking for these opportunities to educate the community. We participate in both large and small events. I encourage any group that is putting on a health fair to contact Onslow Memorial so that we may participate in the event.


The following links provide resources for additional information about stroke, TIA, and important warning signs.

Patient Education Materials (American Stroke Association)
This site provides access to a stroke education toolkit, brochures, and free downloadable educational materials.

Let’s Talk About Stroke Prevention, Risk Factors and Types of Stroke (American Stroke Association)
This webpage includes downloadable PDFs for the following:

  • Hemorrhagic Stroke
  • Transient Ischemic Attack (TIA)
  • About Ischemic Stroke
  • Black Americans and Stroke
  • Hispanic and Latino Americans and Stroke
  • Lifestyle Changes to Prevent Stroke
  • Carotid Endarterectomy
  • Risk Factors for Stroke
  • High Blood Pressure and Stroke
  • Connection Between Diabetes and Stroke
  • Anticoagulants and Antiplatelet Agents

Recognizing a Stroke/Stroke Symptoms
This provides simple steps you can take to recognize a stroke.

Additional Resources:

For more on Clinical Practice Guidelines

American Heart Association Guidelines & Statements