Overview of Ischemic (clot) Stroke
Over a sleepless night, I decided to stop a study of S.F stroke audits where I was drowning in detail – except for two or three items which stand on their own. My background is in a joint article “recovery from stroke” which was put on the NSF web before enableme’s blog which I hope is now home. Another diversion before I get to the point. Detectives who are asked how to solve a crime, say we just followed the money trail. I will do this.
Part one – major acute hospital with a large stroke unit with senior physicians and neurologists in charge, supported by other doctors, physiotherapists, stroke nurses, altogether about 80 years’ worth of stroke qualifications – to diagnose and repair problems due to blood clots. Not to mention any specialist on call. All paid for mainly by the government grants based on each bed/patient day. So never a vacant bed, so when our stroke patient was able to stand and totter a few steps he is prepared for discharge 30 days after admission. Calls by S.F for extra time for therapy shows that they do not understand the main role in the stroke unit is to stabilize the life of the patient. Then treat upper limb within three days and codify defects which may include stroke induced coma, an effect I have not seen in any NSF publication.
Family and social workers will seek out a rehab hospital, often getting out a rehab hospital, often getting the only one with a bed vacancy. The stroke unit will provide a discharge paper, medications and wheel you to the grey transport ambulance.
This article is supported by NSW experience, no carers at this level of stroke, unlike Victoria which appears to have squeezed them in.
Part two – rehab hospital
Patient arrives and the office advises government of extra patient, my understanding is that in NSW, they pay patient/bed subsidy for six months, staff have a simple goal: - prepare patient to return home if that’s what he wants. The day is set to suit physio and O.T exercise requirements. Neurologists and physicians look after mental and physical health. Social workers arrange discharge. I have written about this elsewhere; help families get real carers.
Angus