Stroke is defined as a focal neurological deficit that lasts for more than 24 hours and the etiology is found to be due to vascular origin. There are two main types of stroke are hemorrhagic stroke and ischemic stroke. Most strokes are ischemic stroke, blood clots formation that impedes the blood oxygen supply.
This results in the death of brain cells leading to loss of brain function. Most people recognized this condition as sudden weakness of any body part, mouth drooping that lead to slurred speech or loss of vision. When this happens, immediate action such as seeking medical professional help would make a big difference as time is the brain. Once the patient reached the hospital, a wise doctor would immediately seek for acute stroke team help. This is a specialized multidisciplinary team that consists of a stroke specialist, registrar, speech and language therapist, physiotherapist, social worker and many more.
Each member has a specific role that would help to improve patient survival and quality of life. Once the team is alerted, the patient will be resuscitated accordingly and immediate imaging will be done to exclude hemorrhagic stroke before initiating treatment such as antithrombotic medication. The patient’s medication will be reviewed especially if he/she is on existing blood thinner medication.
Patients also will be put on fasting until they meet the speech and language therapist. This is important to assess the ability for patients to swallow food as aspiration pneumonia is known to be one of the main complications faced following acute stroke. Once the patient is stabilized by the initial management such as an antithrombotic agent or thrombectomy, he/ she will be managed in the acute stroke unit.
An adequate antiplatelet agent such as aspirin is crucial to avoid further deterioration of the patient’s symptoms. Further investigations will be done such as ECG, carotid doppler, echocardiogram and blood cholesterols to identify the cause of a stroke as it can be due to atrial fibrillation, carotid artery stenosis, infective endocarditis, patent foramen ovale and many more. To facilitate patient recovery, a physiotherapist will help with routine exercise that is essential to strengthen muscle power and improve motility.
Speech and language therapist is important for patient rehabilitation especially if there is language impairment that is commonly affecting patients with stroke. An occupational therapist will assess the patient’s ability to carry out the daily activity and manage accordingly. This system is evidence of patient-centred care that is currently the target approach in the healthcare setting. As always, stroke medication is important to help with patient recovery.
If the patient is suffering from atrial fibrillation, an anticoagulant will be prescribed to prevent secondary stroke. Apart from that, some patients may also be bedbound, prevention of deep vein thrombosis via ted stockings or blood thinner at a low dose may be needed. An antihypertensive agent is essential for optimum blood pressure control and antidiabetic medication for a good sugar level. In the long run, antiplatelet such as aspirin will be prescribed life long unless if the patient is on preexisting warfarin.
Since stroke is a major problem worldwide, steps that would improve the quality and rate of recovery following a stroke is vital to be implemented carefully. Every healthcare around the world should consider putting both medications and multidisciplinary teams as their core of management to provide the best health service to the community.
