Stroke is a worldwide problem with high incidence, mortality, disability rates, and costs. A stroke (sometimes called a cerebrovascular accident (CVA)) is damage to the brain caused by an interruption to it’s blood supply or rupture of a blood vessel causing leakage of blood into the brain. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs of the left side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.
Organized Inpatient (stroke unit) Care for Stroke
Earlier, stroke patients were being treated in general medical wards manned by people, the hospital requires a complex package of care, much of which is difficult to evaluate in clinical trials. So instead special care units called ‘Stroke Unit’ have been introduced in the hospitals so that stroke patients can be given special treatment and care.
A ‘Stroke unit’ is a special room (instead of an ordinary hospital ward) with necessary equipments and personnel for treatment of stroke patients. The need of stroke unit was felt long ago and an organized stroke unit care was started in Europe and North America almost 40 years back.
The stroke treatment unit consist of three main components:
- Acute care: Admitted immediately after the patient is affected to give intensive treatment.
- Rehabilitation unit: The unit focuses on restoring the patient’s health and leading them back to normal life.
- Prevention Unit: Continuing care is given to prevent the patient from further incidence of stroke. The stroke units consist of a multidisciplinary team consisting of doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, dieticians, therapy assistants, psychologists, and social workers who are well experienced in stroke treatment.. Other health care professionals are sometimes called on for help if required.
It has been shown that people admitted to a stroke unit have a higher chance of survival than those admitted elsewhere in a hospital, even if they are being cared for by doctors without experience in stroke treatment.
Stroke units have long been known to be effective in reducing morbidity and mortality (decreased by 23%), increasing the proportion of patients returning home, reducing length of stay (by six days on average), improving quality of life for stroke survivors (five out of 100 patients become more independent at home, while four more survive and one less needs to be transferred to a nursing home), and probably reducing overall costs of stroke care. Benefit of stroke unit care was found to be significant for all age ranges. There’s no evidence that stroke units are harmful in any way.
Mobile Stroke Unit
Thrombolytic therapy is the approved treatment for acute ischemic stroke.However, the chances to save the brain tissue by a thrombolytic therapy exponentially decrease with proceeding time after onset of symptoms, the factors for time delay are various like, delay in delivery to the hospital, in conducting CT scans and of blood analysis. This delay can be avoided by using ‘Mobile Stroke Units’ (MSU).
Bringing treatment to the patient rather than the patient to the treatment, enabled by the M.S.U could save precious time lost by transport to and within the hospital. The MSU is an ambulance, equipped with a neurologist and neuroradiologist and includes CT scanner and point of care laboratory unit, intensive treatment can be reached to the patient for emergency diagnosis. The patient is later admitted to the hospital.