Andrew's system shows how the "centre of excellence"
bypass system cannot work over any significant distance.
My department does it in a DGH.
ED initiated
Stoke team as support.
39000 cases per year at ED.
Running at about 3 to 4 completed cases per month
outcome figures slap in the middle of the SITSMOST data
small is beautiful provided it is not too small
APV
On Thu, 15 Nov 2007 10:54:09 +1100
Andrew Stearman <[log in to unmask]>
wrote:
> I can give you an Aussie perspective
> we have a very keen group of neurologists
> involved in multicenter thrombolysis trials.
> An acute stroke neurology on call roster at consultant
>level
> they use the stroke research nurses to be on call
> and they attend the ed for any patients who may be
>suitable for thrombolysis ( 24/7)
> ( they can be called direct from triage and often see
>patients before any doctors )
> the ambulance has a bypass protocol to the tertiary
>referral hospital for acute stroke ? thrombolysis
> but they have to contact the on call neurologist on
>scene to authorise the bypass .( to stop the ED from
>being swamped )
> CT ( perfustion scans ) are usually rapidly avalible
> despite all this they dont get many , I think about
>10-15 a year ( for a catchment of 500000 people and total
>ED attendances of > 100000 for all local hospitals )
>
> contact me off list if you want any of the protocols
>
> regards
>
> Andy Stearman
> John Hunter ED
> NSW
>
>
>>>> Chris Kirke <[log in to unmask]>
>>>>14/11/2007 5:16 am >>>
> We are in the early stages of planning to introduce
>thromblysis for stroke
> in my trust. Does anyone on the list have experience
>with this, or know who
> does? (I think Steve Meek said last year that his
>hospital thrombolysed
> strokes.)
>
> Regards
>
> Chris Kirke
> Whiston ED, Merseyside
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