Friday 16 November 2018

Stroke sufferers in rural areas wait three hours for treatment

Urgent need for a new campaign to inform people of symptoms

Protest: Equipment at Beaumont Hospital needs replacing. Picture: Mark Condren
Protest: Equipment at Beaumont Hospital needs replacing. Picture: Mark Condren
Eilish O'Regan

Eilish O'Regan

People who suffer stroke in rural areas are taking more than three hours to reach hospital, a new report has warned.

It calls for a need to re-activate public awareness campaigns about the symptoms of stroke.

Overall the patient presentation times to hospital after the onset of symptoms remain poor, the National Stroke Register report said.

The report tracked more than 80pc patients who were victim of stroke last year, the majority of whom were over 65.

It found high levels of "wake up" or unwitnessed stroke and the time of onset was not known in 40pc of cases.

The proportion of strokes in men of working age rose slightly from 26pc in 2016 to 28pc.

It found that 69pc of patients were seen by a stroke team within three hours of admission which is up from 54pc the previous year.

The death rate from schaemic stroke, the most common form, is 10.8pc but rises to 36.2pc for haemorrhagic stroke.

More than one in 10 were administered clot-busting treatment and 271 received endovascular thrombectomy for large vessel ischaemic stroke in Beaumont Hospital in Dublin which can substantially reduce disability.

The report said that around 70pc were admitted to an acute stroke unit where the quality of care is higher.

Patients in these units are more likely to have a swallow screen.

A swallow test is important for anybody who has had a stroke, as swallowing ability is commonly affected early after having a stroke.

When a person can't swallow properly, there's a risk that food and drink may get into the windpipe and lungs, which can lead to chest infections such as pneumonia.

The test is simple. The person is given a few teaspoons of water to drink. If they can swallow this without choking and coughing, they'll be asked to swallow half a glass of water.

Ischaemic strokes can often be treated using injections of a medication called alteplase, which dissolves blood clots and restores blood flow to the brain.

This use of clot-busting medication is known as thrombolysis.

However, the report said rates of this procedure remain low in some hospitals although it is impacted by the delay in patients presenting.

It said that 81pc of stroke patients are reviewed by a multi-disciplinary team .

The Irish Heart Foundation and stroke survivors recently protested outside Beaumont Hospital.

The foundation said thrombectomy, a clot retrieval treatment, was being affected.

It said the machine used to deliver it has broken down on a number of occasions, and at times needs to be switched on and off again.

Despite its role in reducing disability there are no plans to replace the equipment at Beaumont, the campaigners warned.

Irish Independent

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