42 HealtH Matters
a project team based in the
midlands has concluded that
clot-busting medication for
stroke is logistically feasible and
safe in an Irish general hospital
setting. Critically important to
optimising implementation of
this therapy is an integrated
community hospital acute
response system for stroke.
C
lot-busting medication with tPa
(tissue plasminogen activator) is the
only licensed, effective therapy for
acute ischaemic stroke. Internationally, less
than one per cent of acute stroke patients
receive this treatment. treated patients have
a 30 per cent greater chance of functional
independence. a key question is whether
this highly time-sensitive acute treatment
can be logistically and safely provided in an
Irish general hospital setting.
the acute stroke service at Midland
regional Hospital, Mullingar set out to
introduce a 24/7 stroke thrombolysis service
in early 2008.
the service sought to:
1. Be the first National ambulance service
(Nas) Division in Ireland to utilise medical
priority dispatch systems to prioritise
emergency response to potential stroke;
2. Be the first Nas Division in Ireland to
train all its paramedical staff in the rapid
integrAted
identification of stroke in the field using
the Face Arm Speech Test (FAST);
3. Provide paramedical advance notification
community
to the Department of emergency
Medicine at the Midland regional
Hospital, Mullingar, of the impending
HoSpitAl Acute
arrival of a Fast positive patient and the
expected time of arrival;
4. Provide immediate and rapid clinical
reSponSe SyStem
assessment of the Fast positive patient
on arrival in the Emergency Department;
5. Fast-track access to Ct brain imaging
for Stroke
and interpretation;
6. Make an immediate decision by the
stroke Physician on the suitability of the
ischaemic stroke patient for intravenous
health matters is 4.indd 42 27/11/2009 20:42:55
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