swosn@lhsc.on.ca 519-685-8500 ext. 32462

Hyperacute & Acute Care

 

Acute care is where the person is stabilized, diagnosis confirmed, plans are implemented to prevent complications, and when initial rehabilitation and recovery begin.

 

 

The period of time from when a person calls 911 to arrival to the Stroke Centre Emergency department is often referred to as the Hyperacute period. All patients with suspected acute stroke would receive rapid assessment and undergo brain imaging on arrival to determine eligibility for the intravenous drug tPA (tissue-plasminogen activator) also known as the “clot buster”. Administration of tPA soon after onset of symptoms can limit irreversible ischemic damage.

A new procedure: Endovascular Therapy (EVT) can sometimes be an option for patients with large artery ischemic strokes. There are 2 EVT centres in the Southwestern Ontario Stroke Network region that perform this specialized procedure: Windsor Regional Hospital – Oulette Site and London Health Sciences Centre – University Hospital. This procedure is available to appropriate candidates 24/7 at University Hospital. This youtube video shows how the procedure is performed: https://www.youtube.com/watch?v=0DQPD5TTS5Y

Patients with an acute stroke or transient ischemic attack would be admitted to a stroke centre and receive care on an inpatient stroke unit. A Stroke Unit is a geographically defined hospital unit dedicated to the management of stroke patients [Evidence Level A]. This unit is staffed by an interdisciplinary health care team who provide coordinated, best practice stroke care. Stroke patients who receive stroke unit care are more likely to survive, return home, and be independent than stroke patients who receive less organized, general ward care (Stroke Unit Trialists’ Collaboration 2009).  Stroke Units can be classified as Acute, Integrated (combination of acute and rehabilitation stroke beds), or Rehabilitation Stroke Units.

The Regional Stroke Centre and every district stroke centre within the Southwestern Ontario Stroke Network region offers specialized acute stroke care on either an acute stroke unit or an integrated stroke unit.

Telestroke is an emergency telemedicine application using videoconferencing technology. Telestroke sites can provide assessment and treatment of patients experiencing acute stroke via consultation with a provincial Telestroke neurologist. The neurologist can view the patient’s CT scan electronically, “see” the patient using live video and discuss results with the patient’s physician. In the Southwestern Ontario Stroke Network region, there are currently 4 telestroke sites providing telestroke services: Alexandra Marine and General Hospital, Goderich; Bluewater Health-Norman Site, Sarnia; Huron Perth Health Care Alliance – Stratford General Hospital, Stratford; and Grey Bruce Health Services – Owen Sound Site, Owen Sound.
  • Approximately 80% of strokes are ischemic and 20% are hemorrhagic
  • 55% of acute stroke patients have dysphagia in the first few days following a stroke
For more information about Acute Care Best Practices related to stroke in the Southwest Region or any of the above, please contact:

Gina Tomaszewski
Regional Stroke Acute Care Coordinator
Southwestern Ontario Stroke Network
University hospital, London, Ontario
gina.tomaszewski@lhsc.on.ca
519 685-8500 ext. 35268