Stroke is a medical emergency which, until recently, offered attendants of a stroke patient this golden window of 4.5 to 6 hours to get treated. But most of this time is wasted by family and friends in either understanding the stroke symptoms or taking the victim to the right hospital which is capable of treating stroke and providing prompt response without any further delay. Each minute wasted between the onset of stroke and the treatment does irreparable damage to patient’s brain cells.
The best and the safest options in case of stroke, thus, lie in taking the patient to a stroke emergency-ready hospital. Each hospital is not stroke ready, not to speak of being stroke emergency-ready. So time taken by friends and family to transport the patient to ‘any’ hospitals in the vicinity is time wasted and if added up it sums up to much more than one would take reaching a stroke emergency-ready hospital.
A stroke emergency-ready hospital:
- understands the emergency nature of a stroke patient
- has a dedicated stroke-focused program
- has dedicated team of professionals specifically trained in stroke care
- operates rapid diagnostic and laboratory procedures 24x7x365
- has an ability to administer intravenous clot-busting medications to eligible patients, and
- capability to provide treatment as per recently-concluded DAWN trial
Treatment based on DAWN trial offers further hope to stroke patients by extending the time window beyond 6 hours to 24 hours. The trial concluded this May that endovascular thrombectomy can be effective in some cases up to 24 hours after stroke. Rapid software was used in this trial and in INDIA we are the first center to use this. It helps in selecting the patients for endovascular thrombectomy. It is a noninvasive procedure that employs a catheter-guided probe enable to remove a blood clot in the brain that has caused the stroke.
But since results from the trial have just come in, and since endovascular thrombectomy needs special training to be carried out, not many hospitals in India, except stroke emergency-ready ones, have been able to adopt it.
Foremost is the use of state-of-the-art dedicated cath lab which emits very less radiation; ensuring safety of the patient further.
Evidence has proved that stroke emergency-ready hospitals provide better care and are associated with better outcomes too, even in case of patients who live and come from outside a 60 minute travel time.
With the capability of carrying out endovascular thrombectomy, the decision to take the stroke patient to a stroke emergency-ready hospital would seem far wiser than running from one hospital to another in the immediate surroundings and keep wasting precious time.
The commonest causes of death and debility seen in stroke patients and of not receiving stroke treatment are these:
- Lack of awareness among public that such treatments exist
- Lack of awareness about symptoms of stroke
- Need to reach stroke emergency-ready hospital in time, and
- Lack of facilities in some hospitals
The situation is further complicated by people’s lack of awareness on stroke symptoms. People suffering from stroke are not in a position to explain much. It is the family members who should be well-informed to recognize the symptoms quickly and get the patient quick medical help.
We are the first center in INDIA to do Mechanical thrombectomy using Clot retiever in AIS
The patient feels problem with coordination, stiffness in muscles, weakness or paralysis on one side of the body, dizziness, double or blurred vision, difficulty speaking or total loss of speech, and reduced sensation of touch.
If you see anyone near you is showing such conditions then it can be a stroke, and you can rely on F.A.S.T. test to confirm and take action. If you ask the person to smile and one side of his face droops, it confirms F-facial dropping. Then ask to raise both arms, you will see one of the arm drifting downwards; it confirms A- arm weakness. Then again ask to repeat a simple phrase and you hear any speech other than the phrase, it confirms S – speech difficulty and at last it is the time to conserve T – time – as stated above, waste none of it and quickly try to shift the patient to hospital equipped with facilities to deal stroke emergencies.
WE are the first hospital in Asia to do mechanical thrombectomy in a 6 year child.