Questions about stroke treatment at Alice hospital

UPDATE Wednesday, July 31

 

A spokesman for the health department has provided the following comment: “We have a town with relatively few stroke patients and those strokes are more likely to be haemorrhagic where this treatment does not work and makes the stroke worse.

 

“The treatment of patients who present with a stroke to Alice Springs Hospital is tailored to the clinical need of the patient and additional advice sought from specialist staff interstate if required.”
By ERWIN CHLANDA

 

To bust or not to bust, that is the question – and it’s one of life and death.

 

The Alice Springs Hospital does not use clot busting medication, other than Aspirin. But Dr Andrew Lee, of the Flinders stroke clinic in Adelaide says clot busting medication is a good thing, coupled with a fast response to stroke symptoms.

 

The issue was raised by the ABC’s Health Report, saying some hospitals around Australia have protocols of fast response to symptoms of strokes and the immediate use of clot-busting medication, and some don’t.

 

Dr Lee, when contacted by the Alice Springs News Online, said: “It’s a good thing, definitely.

 

“The natural response for anyone with the symptoms of a stroke should be dialing 000 and getting to hospital as soon as possible.

 

“From a health care system’s point of view, every health jurisdiction should have some sort of protocol for receiving these stroke patients quickly and more importantly, working them up for a clot busting agent, tissue plasminogen activator or tPA,” says Dr Lee.

 

“On average, for every eight patients you give a clot busting agent to, one will walk out of the hospital completely independently.

 

“If you can get in even more quickly, say within an hour of the stroke happening, and the clot busting agent is given – say – within 90 minutes, then one patient out of every four walks out of the hospital.

 

“The other patients have varying degrees of deficits, but in general, they do better over all.”

 

Dr Winton Barnes, Director Medical and Clinical Services, Alice Springs Hospital and Central Australia Hospital Network, said when contacted by the News: “As a town with a relatively young population, we do not see many stroke patients.

 

“Diagnostic testing is carried out to determine the nature of a stroke event which will determine the type of medication administered.

 

“Alice Springs Hospital does not use clot busting medication, other than Aspirin, as a treatment for patients suffering stroke.”

 

Photo: Clinical Nurse Manager Jeanette Berthelson in the recently opened emergency department of the Alice hospital.

 

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8 Comments (starting with the most recent)

NB: If you want to reply to a previous comment, start your comment with this notation: @n where n is the number of the comment you want to reply to.
  1. Interested observer
    Posted July 21, 2013 at 1:46 pm

    The Canadian Stroke Network’s Burden of Ischemic Stroke (BURST) study (in Drugs.com) found that the direct and indirect health-care costs for new stroke patients tally an average $50,000 in the six-month period following a new stroke (cf $5,000 for the clot busting therapy) … health-care costs fall sharply when people get access to the clot-busting drug tPA, which can significantly reduce post-stroke disability, as well as treatment (costs).
    And keep in mind that even when it doesn’t kill, stroke can leave survivors with life-limiting disabilities. Stroke strips people of their independence, mobility, emotional expression and even dignity (Stroke Foundation).

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  2. Bob Durnan
    Posted July 21, 2013 at 12:00 am

    A problem in this discussion is that the situation relating to the new “anti-clotting” drug has not been fully explained. I did not hear the Health Report in question on the ABC’s Radio National, but my understanding is that these very new drugs are not yet standard treatment, probably because many hospitals cannot yet afford the very high cost of these drugs from within their existing budgets.
    This same problem applies to many other expensive drugs. Most hospitals (and clinics) do not have the resources to stock every expensive wonder drug or new machine that they may or may not end up using before it is out of date.
    It should also be noted that contrary to the views expressed in some of the comments here, these drugs definitely should not be administered immediately on admission to anybody suspected of having had a stroke. A process of establishing the actual cause of the stroke must be undertaken first, as administering an “anti-clotting drug” to somebody whose stroke is caused by a tear or lesion (and not by a clot) could be extremely dangerous, if not fatal, for the patient.

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  3. Interested observer
    Posted July 19, 2013 at 8:08 pm

    The problem with the aspirin treatment provided at our hospital is that aspirin does not dissolve clots. It is effective in preventing them and is given to stroke victims to help prevent more clots but it is not a stroke treatment as such. Unfortunately, we can’t get Alice stroke patients to the Royal Darwin Hospital’s Stroke care Unit quickly enough to be properly treated in time.

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  4. If the
    Posted July 19, 2013 at 7:02 pm

    The point that the information is coming from Adelaide is totally irrelevant. If the information is available it should be used or duty of care is compromised. If Alice Springs hospital fails to give available medication and someone loses their life or their ability to live their life to the fullest then the hospital should be held accountable. I wonder how many Alice Springs people and people from surrounding areas have lost their lives or their lifestyles due to outdated medical advice and treatment methods.

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  5. Bob Taylor
    Posted July 19, 2013 at 1:02 pm

    What is required here is a comment from a Cardiologist or someone qualified in this field of medicine who is prepared to put their name to a comment on this topic.
    [ED – As it is clear from the text, the source we are quoting in our report is Dr Andrew Lee, the Director of the Flinders Medical Center of Stroke, in Adelaide.]

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  6. Stephanie Hart
    Posted July 19, 2013 at 10:04 am

    Good Article, I certainly know of many people in Alice Springs who are in their sixties and seventies, young people are also at risk of stroke if they smoke and are on the pill. I cannot believe that our hospital just use aspirin. I think if someone goes to the hospital with indications that they have had a stoke then they should be given the clot busting medication immediately, they then at least have a chance of a full recovery.

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  7. Tanya Trull
    Posted July 19, 2013 at 7:48 am

    I think they should have it, my daughter has had a stroke and the faster anyone can get treatment the better. One of the awareness campaigns from the stroke foundation is F.A.S.T (face, arms, sentence, time).

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  8. Interested observer
    Posted July 18, 2013 at 8:29 pm

    Excellent article, the statement that “as a town with a relatively young population, we do not see many stroke patients” is an excuse for inaction and is unlikely to be true.
    Diabetes is rampant in our town and outlying bush communities and it greatly increases the risk of vascular disease and in turn stroke risk is increased four fold.
    We may have a population that is young in years but many of our residents pass away aged between 40-50 because their bodies are prematurely aged.
    Problems like vascular disease and stroke are predictably common but often overlooked and untreated due to the poor access to specialists.
    The lack of stroke busting medications here is a major oversight that must not be allowed to be covered up.

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