2022 Rocky Mountain Stroke Conference 

The session recordings are NOW POSTED in the agenda table below. Note - the session recordings are not eligible for continuing education credit.

For Speaker Bios & Session Descriptions, please scroll down.

PRINTABLE AGENDA - PDF

8:00 - 8:30 am - Stroke Survivor Stories: When Personal and Professional Meet

Piper Kmetz, RN, Bozeman Health – Bozeman, MT &
Polly Troutman, RN, Providence St. Patrick – Missoula, MT

As medical practitioners, we face stroke in the acute phase on a daily basis. It’s part of our routine and algorithm to make sure our patients receive the best care possible by going down the checklist, making our time marks and dispositioning the patient to the best level of care for their needs. We are good at what we do and we do it for the sake of wanting the best outcome for our patients. But, what we often don’t see or have follow-up on, are the personal faces of stroke and the life stories behind the patients we treat. “When Personal and Professional Meet” is a reminder to practitioners that every patient we treat is a person with stories and lives that extended far beyond stroke and the hospital.

Polly Troutman, RN, will speak about her family's experience when her Mom survived 3 TIA’s and a right mid cerebral artery stroke in January 2018. She was brought to St. Patrick Hospital where Polly has worked for over 20 years as a Stroke Coordinator, Quality RN, Diabetes Educator, Clinical Educator and now as Neuroscience Program and Palliative Care Manager. Dorinda Troutman has lived in the Bitterroot Valley for over 40 years and is a retired writer and graphic artist for the Ravalli Republic and Rocky MT Rider. She continued writing a very popular column called Bird Seed and serving on multiple committees until her stroke. Her interests are varied and include raising Icelandic chickens, learning about nature and all its wonders, gardening, reading and movies, cooking and exploring the backroads of Montana.  Polly will provide insight on what she thought she knew and what she continues to learn about having a loved one live with a stroke in Montana.

Piper Kmetz is a BSN, RN who has worked in the stroke program at Bozeman Health for 4 years. Prior to that she worked as an ICU RN, ED RN and House Supervisor as well as highlighted in various outdoor professions prior to becoming a RN. 

Bibliographical Resources:
1. Pawlowski, D. (2019). Communicating the significance of home: Stroke survivors and caregivers share their stories. Communication and Theater Association of Minnesota Journal, 43, 29-72.
2. Wilson TC (2019) From professional to patient: hospital experiences of a stroke survivor. Nursing Times [online only]. https://www.nursingtimes.net/clinical-archive/cardiovascular-clinical-archive/from-professional-to-patient-hospital-experiences-of-a-stroke-survivor-10-06-2019/

8:30 - 9:45 am - The Changing Landscape of Stroke Reperfusion Time Windows: Implications For The Field

Ramesh Grandhi, MD, MS, University of Utah Health – Salt Lake City, UT

Mechanical thrombectomy for large vessel occlusion has represented a "game changer" in the field of stroke care. The adherence to time window based protocols, though important initially to prove the efficacy of mechanical thrombectomy, may represent a more limited view on the ability to salvage brain tissue at risk of infarction. In this lecture, we will discuss the evolution of mechanical thrombectomy from a time window perspective, and highlight where the field may go in the future.

Dr. Grandhi is a dual-trained cerebrovascular neurosurgeon who treats vascular pathologies through both endovascular techniques and traditional, open microsurgical approaches. He has extensive experience with patients with cerebrovascular conditions such as arteriovenous malformations, brain aneurysms, intracranial hemorrhages, carotid and intracranial stenosis, and strokes. In addition, Dr. Grandhi has a tremendous clinical interest in patients with Neurotrauma and has made notable contributions in this regard on a local and national basis. He is the Division Chief of Neurotrauma within the Department of Neurosurgery and serves as the Surgical Co-Director of the University of Utah Stroke Center. 

He received his undergraduate degree from Duke University and a master’s degree in physiology at Georgetown University. Dr. Grandhi attended medical school at Virginia Commonwealth University and did his residency at the University of Pittsburgh Medical Center, where he completed an enfolded fellowship in Interventional Neuroradiology. He then completed a fellowship in Cerebrovascular Neurosurgery at the Baptist Neurological Institute in Jacksonville, Florida.

Bibliographical Resources:
1. American Heart Association Guidelines for Acute Ischemic Stroke, 2019
2. Defuse 3, New England Journal of Medicine, 2018

10:05 - 11:05 am - SYNAPSE - Connecting, Empowering and Inspiring Youth to Knock-Out Stroke!

Jason Gleason, DNP, NP-C, USAF Lieutenant Colonel (RET) - Great Falls, MT

The audience will be taken through an immersive journey on how to build, launch and sustain dynamic stroke education programs for high school, middle school and elementary students empowering them to prevent, recognize and knock out stroke in their communities. 

Dr. Jason Gleason, better known as Dr. J holds a doctoral degree from Montana State University and has been working as a board-certified nurse practitioner since 2001.  Dr. Gleason has an expansive professional portfolio which includes 20 years of service in the USAF/Air National Guard before retiring as a Lieutenant Colonel in 2015. He has demonstrated expertise in the fields of family practice, emergency medicine, primary care, diabetes and stroke care and he is also a lauded national speaker and consultant.  He currently provides primary care services for our National Heroes at the Veterans Health Administration and serves as a faculty member at Fitzgerald Health Education Associates which is the premier provider of NP board review and NP continuing education in the country. Dr. Gleason serves on multiple local, state, and national councils and boards including the Benefis Health System Stroke Council, the Montana State Stroke Workgroup, the National VA Stroke Clinical Practice Guidelines Workgroup, the National VA APRN Council, and the Corporate Advisory Board for Carelinx by Sharecare and innovative home care services company launched by WebMD founder Jeff Arnold, Oprah, Remark Media, Sony Pictures Television and Discovery Communications. Gleason has been recognized from the floor of the United States Senate for his work with stroke and Veterans. Out of all the roles he has had in his lifetime the most profound is being a dad to his three amazing sons.

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Bibliographical Resources:
1.  Smith, Angela L, et al. “Stroke Education in School-Age Children.” Stroke, vol. 50, no. Suppl_1, 2019, https://doi.org/10.1161/str.50.suppl_1.tp227. 
2.  Matsuzono, Kosuke, et al. “Effects of Stroke Education of Junior High School Students on Stroke Knowledge of Their Parents.” Stroke, vol. 46, no. 2, 2015, pp. 572–574., https://doi.org/10.1161/strokeaha.114.007907.

11:10 am - 12:10 pm - Conducting a Stroke Neurological Examination

Todd Mohr, PA-C, Healthcare Provider Education and Quality Program Coordinator, St. James Healthcare - Butte, MT

The instructor will demonstrate a neurologic examination on a patient suspected of experiencing a stroke.  The session will cover the pre-hospital and in-hospital initial stroke examination including stroke screening and stroke severity scales.

Todd Mohr is a Physician Assistant working at St. James Healthcare in Butte. He has worked in the Emergency Department at St. James for 15 years. Todd grew up in Deadwood, South Dakota and became interested in helping others as a teenager when he joined the Volunteer Fire Department at age 14 as a Junior Volunteer. He became an Emergency Medical Technician and worked on the Ambulance at age 16. He joined the US Air Force at age 17 as a Fire Protection Specialist and quickly rose through the ranks. Todd served primarily as a Rescue Crew Chief and was responsible for motor vehicle accident patient extrication, aircraft crash pilot rescue and was assigned to the Space Shuttle Rescue Team while stationed in Germany. He completed the Air Force Physician Assistant Program 25 years ago and was assigned to Malmstrom AFB in Great Falls, Montana. He thoroughly enjoys the opportunities that Montana provides his family to spend time together in their passion for golfing, skiing, and hunting. His other noted patient care experiences include serving as a SWAT Medic and on Helicopter EMS. Todd is the Medical Director for several Volunteer EMS Services in Southwest Montana and believes it is his way to "give back to his roots" which has allowed him to have the "most blessed career experiences in the world!"

Bibliographical Resources:
1. Neurologic Examination at 24 to 48 Hours Predicts Functional Outcomes in Basilar Artery Occlusion Stroke -https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.116.014567
2. Initial Assessment and Management of Acute Stroke - https://www.uptodate.com/contents/initial-assessment-and-management-of-acute-stroke

1:15 - 2:15 pm - Best Practices for Your Patient After Hyperacute Stroke Interventions

Kailey Cox, BSN, RN, SCRN, Stroke Program Coordinator, Providence St. Vincent Medical Center - Portland, Oregon.

The presentation will include interdisciplinary care best practices for the stroke patient after being treated with hyperacute stroke treatments such as thrombolytic, thrombectomy, and/or carotid endarterectomy or stent. This will include details of neuro assessment, the rationale for such assessment, site checks, pulse checks, general nursing care specific to the stroke patient.

Kailey Cox BSN, RN, SCRN has worked in healthcare since 1998 and has been a nurse since 2005. She has spent the last 7 years as the Comprehensive Stroke Program Coordinator Nurse for Providence St. Vincent Medical Center with over a decade of experience in the stroke program coordinator nurse role. She has authored and presented multiple abstracts including a podium presentation at the International Stroke Conference on topics ranging from standardized stroke neuro assessment, standardized process for inpatient code strokes to standardized feedback for EMS about stroke treatment cases. She is also the owner/operator of “Kailey’s Art for Brains” where she creates brain-themed art for the benefit of The Aphasia Network and Sarah Bellum’s Bakery, a workplace rehab for brain injury and stroke survivors. She lives in Portland, Oregon with her husband of almost 20 years and their two dogs, Sushi and Sigi.

Bibliographical Resources:
1.  Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association. Originally published11 Mar 2021https://doi.org/10.1161/STR.0000000000000356Stroke. 2021;52: e164–e178
2.  Care of the Patient With Acute Ischemic Stroke (Endovascular/Intensive Care Unit-Postinterventional Therapy): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association. Originally published11 Mar 2021https://doi.org/10.1161/STR.0000000000000358Stroke. 2021;52: e198–e210

2:50 - 3:15 pm - MT Stroke Initiative - Trends/Data

Joani Guzman, Mission: Lifeline Montana, American Heart Association - Billings, MT

This session will discuss enhancing MT’s stroke system of care by connecting the links in the stroke chain of survival. Including the current state of stroke care and the latest data trends in MT.

Joani Guzman leads the charge for the Mission: Lifeline Stroke Montana Initiative. As a Quality Improvement Manager for the American Heart Association, her primary focus is on establishing relationships between each chain in the link of survival, surveying education and resource needs, and getting those tools into the hands of health care providers. Joani directed the Mission: Lifeline Montana STEMI project from 2014-2018 where a task force of key stakeholders laid the solid foundation for Montana’s STEMI System of Care before passing the torch onto Montana’s DPHHS.

Bibliographical Resources:
1. https://professional.heart.org/en/science-news/2021-update-care-of-the-patient-with-acute-ischemic-stroke
2. www.heart.org

3:15 - 4:30 pm - Stroke Case Presentation with Panel Discussion: Emphasizing Rural Access

Moderator - Penny Clifton, MSN, RN, CNRN, SCRN -St. Vincent Healthcare, Billings
Panelists - Mark Elliot, MD, Inland Imaging - Missoula, MT
Ramesh Grandhi, MD, MS, University of Utah Health - Salt Lake City, UT
Alexandria Goffena, BSN RN, Roundup Memorial Health Care - Roundup, MT
Michelle Dorough, NRP, FPC, American Medical Response - Bozeman, MT
Amy Mazzarisi, MSW, RN, CFRN, CCEMTP, Logan Health - Kalispell, MT

A multi-disciplinary panel of health care providers who deal with stroke will present and discuss real stroke cases that highlight the unique challenges of providing timely stroke intervention and care in a rural setting.

Penny Clifton, MSN, RN, CNRN, SCRN, has been an RN for 40 years specializing in neurocritical care. Stroke Coordinator at St. Vincent Healthcare, Billings MT, since 2010

Dr. Mark Elliott, MD is an Interventional Radiologist with Inland Imaging in Missoula, MT. He is a Montana native from Havre and has been practicing in Missoula for nearly 28 years. Dr. Elliot has performed acute stroke intervention for over 11 years and is interested in all Montanans having access to effective and timely acute stroke treatment and care.

Ramesh Grandhi, MD, MS, University of Utah Health – Salt Lake City, UT – See Dr. Grandhi’s bio above.

Alexandria Goffena, BSN RN, has been a nurse for 17 years with experience in ICU, Pre-op/PACU, ER, and Trauma.  Her experience has been in both Level 2 Trauma Centers and Critical Access Hospitals.  She is currently the Assistant Director of Nursing, Trauma Coordinator, and manager of the hospital and emergency room at Roundup Memorial Healthcare.

Michelle Dorough, NRP, FPC is the Clinical Education Supervisor for American Medical Response in Bozeman, Montana.  Michelle has been in Emergency Medical Services for 26 years as a Flight Paramedic, 911, and Ground Critical Care.

Amy Mazzarisi, MSW, RN, CFRN, CCEMTP has been an RN for 10 years in emergency departments, intensive care units, and critical care paramedic for over 16 years. She currently works as a flight RN at A.L.E.R.T. out of Kalispell, Montana.  Amy is a passionate, outdoors wilderness adventurer and a seeker of solitude. She is also found at home with family, friends, pets, and her flower gardens.

Bibliographical Resources:
1. Front. Neurol., 22 January 2021 | https://doi.org/10.3389/fneur.2020.582605. The Next Step in the Treatment of Stroke.
2. National trends in endovascular therapy for acute ischemic stroke: utilization and outcomes. J Neurointerv Surg. 2020; 12: 356-362