Devon Air Ambulance is sometimes called to assist with Inter Hospital Transfers (IHT) but more recently, they have undertaken a new ‘Rapid Transfer Service’ for stroke patients.
Strokes are the second most common cause of death worldwide. 85% of strokes are caused by a blockage (a clot called a thrombus) in the small blood vessels of the brain, and the remaining 15% occur as a result of a bleed in the brain. Administering emergency clot-busting drugs has been the mainstay treatment for many years but risks further complications. Developments in treating these thrombolytic strokes continue to improve not only survival, but the quality of life for those that do survive.
Some thrombolytic strokes are now treated using a relatively new procedure similar to that used in the treatment of heart attacks.
Removal of the thrombus (clot) is undertaken with a guide wire, inserted into a large artery in the leg, which travels along blood vessels to reach the target, and the thrombus is removed. This procedure is called Mechanical Thrombectomy Retrieval (MTR) and is performed by specialist Neuro Interventional Radiologists at University Hospitals Plymouth using x-ray type images to help them carefully navigate the complex network of blood vessels in the brain. The aim is to remove the thrombus, so that normal blood flow can be restored to the part of the brain which has been starved of oxygen.
Results for MTR are impressive. In some cases, patients can have severe one-sided paralysis at the start of the procedure and wake up afterwards moving all four limbs normally. Patients suffering this kind of sudden stroke are time critical, and MTR should be performed as quickly as possible as the benefit of MTR drops by 5.7% for every hour of delay. In Devon, the longest transfer time to the hospital in Plymouth is undertaken by patients being treated at the North Devon District Hospital in Barnstaple. Between the two hospitals, the road transfer can take up to two hours, but by air, it can be as quick as twenty minutes.
Anaesthetist, Dr Anna Ferguson, first approached Devon Air Ambulance with the idea of reducing this transfer time. In partnership with Plymouth and Barnstaple hospitals. Advanced Paramedic in Critical Care and Research Lead at Devon Air Ambulance, Nigel Lang, worked with Dr Ferguson to develop the system which now provides rapid air transfer for these time critical emergencies across the county.
So far, fourteen patients have benefited from this new service, and it is anticipated that numbers will increase as the MTR service expands. MTR is not yet a 24/7 service, however it is hoped this will be achieved within the next few years. MTR is an expensive procedure, however due to reduced hospital stay and social care needs, cost savings can be huge; and the benefit to patients and their families can be even bigger.
The main stroke symptoms can be remembered using the word FAST:
Face – their face, mouth, or an eye may droop on one side, and the person may not be able to smile.
Arms – the person may not be able to lift both arms and keep them there.
Speech – speech may be slurred or garbled; they may not be able to talk; and may have problems understanding what you’re saying.
Time – dial 999 immediately.
Visit the NHS page for more information relating to Strokes.
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