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Theme II: Optimizing Acute Stroke Care
Stroke is Treatable
In the past few years, major advances have been achieved in stroke treatment. The Canadian Stroke Network aims to optimize stroke care so that all patients have access to the full range of appropriate treatments. A unique characteristic of stroke, compared to other brain conditions, is that within certain time constraints it is treatable. If a patient recognizes what is happening as a stroke, rapidly gets to an emergency room (ER), and this particular ER gives the patient priority access to a CT scan, and the scan does not show any haemorrhage in the brain, and t-PA is started within 3 hours from the onset of symptoms, the patient’s deficit is much reduced, and sometimes totally eliminated.
What percentage of stroke patients receive t-PA? Our research shows that only about 7% of eligible patients get the drug. Why? Do they not recognize the symptoms? Can they not find adequate transportation to an ER? Do they end up in an ER that is unprepared to treat them? What happens to the patients after they enter hospital? Do they go to a specialized ward, or to a general medicine ward? Are they admitted at all? If they are, do they get adequate nursing care? Adequate physiotherapy? What percentage is back at work within 6 months? These and other unanswered questions are the reasons the CSN has set up the Registry of the Canadian Stroke Network, where data on stroke patients are being collected in small and large hospitals across the country. The information is then anonymized and centralized at the Institute for Clinical and Evaluative Science (ICES) for analysis.