Ambulance staff can speed up stroke treatment

Treating stroke in specialised ambulances en route to hospital is feasible and could boost the number of patients who receive lifesaving therapy experts believe

Mobile stroke units can halve the time it takes a patient to get clotbusting drugs a small German trial found

The drugs only work if given within four and a half hours of stroke onset

Since not all patients are suitable candidates a rapid assessment is critical The Lancet Neurology reports

Clotbusting drugs thrombolytics can be effective if the stroke is caused by a blood clot the cause in about 80 of cases but not if it is due to a bleed

The faster an eligible patient receives clotbusting treatment the better their chances are of surviving and reducing longterm disability

Brain scan
The latest trial which involved 100 patients in Germany found treatment decision times were reduced by equipping ambulance staff with the necessary tools including CT scanners to diagnose and manage stroke

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Treating suspected stroke patients at the site of the emergency is an interesting development

Nikki Hill
The Stroke Association
In the study thrombolysis was given within 35 minutes on average for those patients treated by mobile stroke units In comparison those sent to hospital for treatment in the usual way waited 76 minutes

Patient outcomes did not differ significantly between the two groups but the researchers point out that the study was not designed to evaluate this and that the number of patients involved in their trial was small The follow up was also short a week

Experts say larger studies are needed to explore what impact earlier treatment will have on prognosis and to confirm whether mobile stroke units would also work in other geographical regions not just in urban areas with short journey distances

Stroke is the third biggest cause of death in the UK and the largest single cause of severe disability Each year more than 110000 people in England will have a stroke which costs the NHS over 28bn

In 2007 the government set out a National Stroke Strategy to improve stroke services and recommended that patients with a suspected stroke should have a brain scan as soon as possible to determine if it was caused by a blocked artery or a burst blood vessel

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A stroke can be diagnosed using FAST

Facial weakness has the persons face drooped usually down one side
Arm weakness is the person able to lift both arms above their head
Speech problems does the persons speech sound slurred
Time to call 999 if one or more of these symptoms are present call 999 immediately
Only a minority of stroke patients reach hospital and undergo brain scanning within a few hours which is necessary if these drugs are to be given

But stroke care has been improving over recent years audits show

Nikki Hill of The Stroke Association said When a stroke strikes time lost is brain lost meaning that getting urgent medical attention quickly is absolutely essential

Treating suspected stroke patients at the site of the emergency is an interesting development and it could help to speed up the whole treatment process for some patients

However this research was conducted in an urban area of Germany and so its difficult to say whether the same method would work in the more rural areas of the UK A lot more research is needed

A Department of Health spokeswoman said The results of this study are interesting but we would need more evidence on whether mobile stroke units would be a clinical and cost effective addition to NHS stroke services

In some instances it could be just as quick or quicker to get the patient to hospital in an ambulance as it would to get a mobile stroke unit to the patient

Date : 11 Apr, 2012
Reference : http://www.bbc.co.uk/news/health-17664024

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