Why did I create a progressing stroke group? There are strokes which do not fulfil the F.A.S.T signs and symptoms. I had such a stroke where the only symptom was my eyes focusing in different directions. It’s only after 4 days that everyone agreed I was having a stroke. By this time, it was too late to get rid of the clot using thrombolysis. Thrombolysis is only done in the 3 – 4 hour window at the start of the stroke. This is why I started the progressing stroke group.
I believe that this type of cerebrovascular accident happens a lot more often than we realise and needs to be diagnosed as early as possible. I believe, also, that the thrombolysis window needs to be extended to much greater than 4 hours for this type of stroke. The group needs to pressure the NHS to make sure that all treatments are truly patient-centred and that evolving strokes are treated as such.
Why progressing stroke
I had none of the F.A.S.T signs and symptoms. Even the staff in A & E didn’t know what was wrong with me. It took around 12 hours for them to decide it might be a stroke. It took another 4 days for the Stroke Team to abandon their wait-and-see approach and actually admit I was having a stroke. This tells us that all staff in A & E should be able to recognise a progressing stroke.
Role of family
- Staff should train the family properly on how to communicate with stroke patients. This should be done while the patient is still in hospital preferably during rehabilitation.
- Families should know what to expect – not just the physical symptoms but behavioural, mental, balance etc – and how to amicably deal with these symptoms. The progressing stroke group would make sure of this.
- Staff and family and friends should not speak on behalf of the patient unless the patient agrees with the interpretation.
- Staff, family and friends should not assume that having a stroke means the patient is now stupid! Nor should they assume that older patients are more stupid than younger ones. All that is far from the truth!
Role of healthcare professionals in progressing stroke group
- A progressing stroke is speedily and accurately diagnosed so that corrective measures, such as clot busting, can be done as quickly as possible.
- All staff should know how to communicate with the patient. They should not assume that the patient or the person accompanying the patient has medical knowledge.
- A CT scan is performed as soon as the patient arrives at A & E and the radiologist gives a verbal report immediately.
- The 3 – 4 hour clot busting window is revisited for this type of stroke. It should still be possible to bust the clot months later.
- The wait-and-see approach, by the A & E department or the Stroke Team, should be seriously questioned.
