Patients who have had ischaemic strokes and fit a strict range of criteria will in future receive Thrombolysis, a potentially life saving treatment that will be administered on the Island.
Over the past 2 years the Island’s NHS has been implementing a plan to redesign local stroke services in line with the 20 quality markers within the National Stroke Strategy and has now been given the go ahead to introduce the provision of Thrombolysis for eligible patients. A full 24 hour, 365 days a year service will be in operation from this summer to make decisions about treatment given at the very early stages of stroke. Decisions around treatment will be made locally by in-house Consultants between 9am and 5pm Monday to Friday. Outside these hours decisions will be made via a telemedicine link with colleagues at Portsmouth Hospitals NHS Trust.
Karen Baker, Chief Operating Officer at St. Mary’s Hospital, said: “We are fully committed to developing stroke services on the Island and the delivery of Thrombolysis is a major step forward, for us and for stroke patients. A significant amount of redesign and investment has already been made to make the stroke service even better and further improve the overall outcome for patients.”
Last year the Island’s NHS saw an average of 28 stroke admissions to St. Mary’s Hospital per month (336 per year). All potential stroke patients are currently assessed in the Emergency Department and investigated by a specialist stroke team before being admitted directly to the Stroke Unit in order to ensure specialist input from an early stage. Soon patients who are considered eligible for thrombolysis treatment will be admitted for the first 3 days of their care to a ‘Hyper-Acute’ Unit at St. Mary’s Hospital where care is more intense and where they will be monitored more closely during the acute phase of their treatment which is usually days 3 – 7. This is when patients still require close monitoring but without the initial greater intensity.
Jeannine Johnson, Clinical Lead for Stroke, said; “Early recognition of stroke symptoms is of particular importance as there is only a 3 hour window between onset of symptoms and delivery of this anti thrombotic drug. It is important to recognise that only around 10% of those experiencing ischaemic stroke (as opposed to a bleed) will be eligible for this intervention due to a very strict exclusion criteria (about 30-40 people a year). However those eligible will have the potential for a much better recovery and final outcome.”
The Island’s NHS currently provides a 7 day a week clinic that facilitates the assessment and investigation of people experiencing transient stroke symptoms (mini stroke) that could, if not correctly treated, lead to a larger more permanent debilitating stroke. Significant investment has been made in a Community Stroke Rehabilitation Team that aims to facilitate earlier discharge from hospital to home. This team is one of only two in the country that consist of a full multi disciplinary stroke team (including nurses) that have the specialist skills to deliver a 7 day a week service within the patient’s own home.
Jeannine Johnson continued: “Our Community Stroke Rehabilitation service has proved to be a very successful service; in the last month nearly 60% of all discharged stroke patients went home with this team’s input. The feedback from both patients and their families has been wholly positive, but we are still making further improvements in the way this service is delivered to ensure more people can benefit.”
The key to making a good recovery from stroke and the eligibility of receiving thrombolysis is recognising the symptoms as soon as they strike. The Act F.A.S.T. campaign uses a simple checklist to help everyone recognise the tell tale signs of stroke and advises of the action to take. The main symptoms can be remembered easily with the initials F.A.S.T.
Face - has their face fallen on one side? Can they smile?
Arms - can they raise both arms and keep them there?
Speech - is their speech slurred?
Time - it’s time to call 999 if you see any of these signs.
Prompt action after a stroke is vital as it can prevent further damage to the brain. A delay can result in major long term disabilities; that is why it is crucial for as many people as possible to learn how to act F.A.S.T.
More information about the Act F.A.S.T. campaign and stroke can be found at http://www.nhs.uk/actfast/pages/about-stroke.aspx. More information about thrombolysis can be found at http://www.nhs.uk/livewell/stroke/pages/everysecondcounts.aspx.
Notes for Editors
1. Every year around 110,000 people in England have a stroke. It is the third leading cause of death and there are at least 300,000 people in England living with disabilities, as the result of a stroke.
2. There are two main types of stroke:
- Haemorrhagic stroke: caused when a weakened blood vessel in the brain bursts. This produces bleeding into the brain, which leads to damage.
- Ischaemic stroke: caused by a clot or narrowing or blocking of blood vessels, so that blood cannot reach a particular area of the brain, this leads to death of the brain cells due to lack of oxygen.
3. A mini-stroke is called a Transient Ischaemic Attack or TIA. It is similar to a stroke and has the same signs, but it gets better within 24 hours. A TIA could be a warning sign of a more serious stroke.
4. The risk factors of stroke are high blood pressure, diabetes and high blood cholesterol. Preventative advice includes:
- Be physically active and exercise regularly
- Avoid being overweight by keeping to a healthy diet
- Limit alcohol consumption
- Avoid cigarette smoke. If you smoke seek help to stop now.
- Learn to recognise the warning signs of a stroke and how to take action F.A.S.T.