Mediclinic’s stroke project reaps significant benefits
Mediclinic hospitals across South Africa are on standby to provide expert and efficient treatment for stroke patients.
“We started our stroke unit nearly 20 years ago, and we’ve come a long way. We are ready for these patients, and a system is in place to expedite their treatment. I can’t think of too many hospitals around the world where it happens as efficiently as it does at this one.”
Dr John Gardiner is an experienced neurologist at Mediclinic Constantiaberg who has seen how the management of stroke patients has evolved over decades. Today, he plays a key role in treating and managing patients who present at the hospital’s Emergency Centre with signs of a stroke.
That process is based on a simple premise: time is brain.
Strokes can be broadly divided into haemorrhagic strokes, where a blood vessel ruptures and blood flows into the brain substance under pressure. The other type is an ischaemic stroke, where a vessel becomes blocked, cutting off oxygen from the brain.
Both can have dangerous and lasting effects on the brain. “The brain tissue is the only tissue that can’t withstand a lack of oxygen,” Dr Gardiner explains. “This means the brain is damaged within minutes of a stroke occurring – and the brain has no natural recovery process to reverse that damage.”
Paramedics, nurses, radiologists and doctors all play an essential part in controlling the extent of that damage. “The good news is that the right treatment can have a life-changing impact for patients. It can mean being able to walk again.”
The key is time. The earlier a stroke victim is received at the Emergency Centre, the better, as doctors need time to give that patient a CT or MRI scan to determine which kind of stroke they are dealing with, so that they may administer the most appropriate treatment plan.
Thrombolysis, for example, is a form of treatment often used to treat ischaemic strokes by breaking down the blood clots formed in blood vessels. However, it is not used in cases of haemorrhagic stroke, as it can be life-threatening. Another new and promising form of treatment is a thrombectomy, an interventional surgical procedure which entails removing a blood clot from the blood vessel.
We treat strokes with a team approach, and that team approach starts on the scene, Dr Gardiner says. “The paramedics need to be aware that any delays can compromise brain function, and the public needs to know what they are seeing so that they can react quickly.”
To recognise the signs of a stroke, remember the acronym FAST: Face drooping, Arm weakness, Slurred speech and Time to move.
“Studies have shown that patients on average will wait 20 to 30 minutes before they’ll tell anybody about their symptoms,” says Gardiner. “I think it’s largely because of fear of the unknown. But our stroke treatment protocols are world class, and we are ready for you. If it occurs to you that there may have been a stroke, get the patient to the professionals as soon as you can.”