Stroke service success
The new hyper-acute stroke service has seen significant improvements in stroke care for patients across Tayside.
The recently-published Scottish Stroke Improvement Programme National Report highlighted a number of areas of progress during 2019.
This includes performance against the‘stroke bundle’targets of CT scan in 12 hours, swallow assessment in four hours, admission to stroke unit within a day and aspirin if appropriate within a day.
Despite the challenges of the COVID-19 pandemic the team at the acute stroke unit, based in Ninewells Hospital, continued to see and treat people 24/7 and the number of patients receiving the stroke bundle has continued to rise since its inception 10 months ago.
The percentage of people receiving thrombolysis – medication to remove blood clots – has steadily increased from seven per cent to around 20 per cent. This is at the upper level of what is expected in a highly functioning stroke unit.
There has also been a significant reduction in‘door to needle time’, which is the time between patients arriving in hospital and receiving thrombolysis.
The proportion of those receiving the treatment within 30 minutes of arrival has increased from 13 per cent to 50 per cent, with 75 per cent being treated within one hour.
NHS Tayside consultant and clinical lead for stroke services, Dr Matthew Lambert, said:“The team in Tayside has made significant changes to the pathway of care for people who have a stroke, with the aim of improving timely access to a stroke specialist team and to the treatments and care that we know improve the chance of recovering from stroke.
“It is great to see these improvements already in a number of different areas of care and we will continue to build on these.
“The service has continued all throughout the COVID-19 pandemic and, as a result of more public awareness of stroke and its symptoms, we are pleased to have seen an increase in people seeking medical help within the first few hours of a stroke, when there is much more we can do to reduce the damage.
“I would encourage anyone who has symptoms of a stroke – facial weakness, arm weakness, speech problems – to call for help urgently by dialling 999.”
Patients from across Tayside are admitted to the new acute stroke unit seven-days-a-week, with 24/7 input from stroke specialists.
In many instances, patients can now also bypass the traditional route through the emergency department or acute medical unit to be taken directly to the stroke unit for diagnosis and assessment.
This means that patients are getting earlier access to specialist treatment before being discharged home or stepped down to their local stroke unit for ongoing care and rehabilitation.
Further changes are planned to take patients directly to the radiology department for scans which would allow thrombolysis to be delivered even quicker.