Stroke: quick action could save a life

Mediclinic’s integrated model for stroke care across all our hospitals ensures stroke patients are treated as fast as possible in the most appropriate facility.

Time is brain

Stroke is one of the leading causes of death and disability in the world. It occurs when there is a problem with blood flow to the brain, either because of a blocked artery or bleeding in the brain. The main principle in stroke treatment is “Time is brain”, in other words, the faster the treatment, the better the outcome. Knowing the warning signs of a stroke and taking prompt action can help save a life and prevent long-term debilitating effects.

“Strokes may be life-threatening, but there is an opportunity for intervention if one acts timeously,” confirms Dr Zunaid Mohamed, Head of the Emergency Centre (EC) at Mediclinic Cape Gate. “There is a window of intervention, which, if managed appropriately, can turn the situation around and preserve brain function. By initiating treatment quickly, there’s a chance of reduced long-term disability, mortality and an improved quality of life.”

At Mediclinic, staff across a range of disciplines are trained to recognise the warning signs of a stroke. “We have protocols in place so we can quickly identify and treat emergencies like strokes,” says Dr Mohamed. “This applies across the ambulance service, Emergency Centre, radiology department, physicians and neurologists, and beyond this to the rehabilitation process involving physiotherapists and occupational therapists.”

Stroke readiness at Mediclinic ECs

The protocols Mediclinic has put in place include standardised timelines to initiate treatment as quickly as possible and for a quality review of treatment to ensure positive outcomes. ER24, Mediclinic’s pre-hospital ambulance service, is also on board with these protocols and staff are well trained to manage strokes.

“ER24 will pre-notify hospitals in the event of a stroke patient, which allows our Emergency Centres to be prepared when they arrive. On arrival, we conduct a rapid triage to assess the possibility of a stroke. The radiology department is then informed and can facilitate a CT or MRI scan as quickly as possible.”

Based on the findings, the next steps are taken. For example, thrombolytic drugs to help break down any clots and prevent further injury, may be given. “For thrombolytic medications to be beneficial, they need to be given within four-and-a-half hours of the onset of the stroke,” Dr Mohamed explains. They are not suitable for everyone, however. A second possible intervention is a mechanical thrombectomy to remove the clot from the vessel. Mediclinic Cape Gate has a specialist interventional radiologist to conduct this procedure.

Know how to act, FAST

It’s important to educate patients and their families to identify a stroke at home so they will know to come directly to an Emergency Centre or call an ambulance. “Getting to a hospital as soon as possible will ensure an assessment can be done, reducing the gap between diagnosis and treatment,” Dr Mohamed says.

Healthcare professionals use the FAST acronym to help determine if a stroke has occurred:

F is for face – is there paralysis or muscle weakness or a droop on one or both sides of the patient’s face?

A is for arms – can they raise their arms and is there a sign of muscle weakness on one side?

S is for speech – can they speak and choose the right words when they do so?

T is for time – don’t wait to get help. Make a note of when the symptoms began and contact a healthcare professional as soon as possible so they can determine the best treatment options.