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Stroke Thrombolysis & the BAT
Introduction
The LGI is beggining to thrombolyse ischaemic strokes. It is hoped that this will increase the number of patients who make a full recovery from their stroke from 38% to 50%. Unfortunately it will also lead to an increased rate of intracranial bleed BUT the overall survival at 3 months remains the same.
To safely achieve this the patient has to be CT scanned and undergo rigorous assessment of multiple inclusion and exclusion criteria within 3 hours of ONSET of symptoms. This is a complex challenge and to help us do this we have the services of the Brain Attack Team. At the moment this team is available from 09-17.00 and only includes patients aged 18-80 years.
The Role of the ED
The ED teams role is to identify patinets with new onset neurological dysfunction that has occured within the last three hours. Any patient who presents in this way should be identified using by paramedics /IAT using the FAST (Face, Arm, Speech Test)and transferred to Resus for a more thorough review by a middlegrade or consultant ED doctor. The ED team should begin the Stroke Pathway EDPD which is 9 pages long and can be printed off from this page (below)
If the diagnosis is thought to be a new onset stroke the ED team should contact the Brain Attack Team Co-Ordinator (office 25725 mobile 07786 250793)
and initiate the CT scan. It is important to highlight to the radiology team that the patient is potentaily for stroke thrombolysis as this should expedite the scan.
The BAT will then perform an in depth assessment and complete the multiple pages of documentation. They will also make the final decision to thrombolyse or not, and also give the drug.
PAC 3/9/07