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Country hospitals get around the clock stroke support

June 14, 2018
Country South Australians who experience a stroke will now be able to access additional clinical support 24 hours a day, seven days a week at rural and regional hospitals across the state.

Country Health SA’s Executive Director Medical Services, Dr Hendrika Meyer, said from this month, neurologists at metropolitan stroke units will be able to support country stroke patients at the state’s 61 country hospitals via phone and videoconference at any time of day.

“The neurologists will help country doctors quickly identify patients suitable for transfer to Adelaide, or those who can receive their treatment close to home,” Dr Meyer said.

“The new and improved model of care enables faster and more accurate decision making, which will lead to improve patient outcomes.

“Commencing this after-hours neurology support is a real game changer for country stroke patients, and I would like to thank Country Health SA and our metropolitan-based neurologists for working together to bring this about.”

Dr Meyer said the two main types of acute stroke treatment are thrombolytic therapy, which uses medication to break down clots and remove the blockage in blood flow to the brain, and endovascular thrombectomy, which involves surgery to remove the clot from the brain.

“Thrombolytic therapy has been available for suitable stroke patients at the three country stroke services – Mount Gambier Hospital, Whyalla Hospital and Riverland General Hospital – for several years, with the support of the metropolitan stroke units,” Dr Meyer said.

“Until now this service has only been offered during business hours, Monday to Friday, however with additional support from metropolitan neurologists, this will expand to 24 hours a day, seven days a week, which is a turning point for country stroke patients.”

City-based neurologist who assesses country stroke patients, the Royal Adelaide Hospital’s Head of Unit and Clinical Director Stroke for Country Health SA, Associate Professor Tim Kleinig, said the new model was especially important for those country hospitals where there are no CT facilities available.

“Being able to videoconference will allow the neurologist to remotely examine the patient, to support the local care team in determining the best care pathway,” Associate Professor Kleinig said.

“Depending on the patient’s symptoms and prognosis, we can provide support to the local care team to enable access to specialised stroke care closer to home or initiate the transfer of the patient to Adelaide, where they could undergo an endovascular thrombectomy at the RAH.”

Associate Professor Kleinig reminded anyone who thought they may have experienced a stroke to call an ambulance and seek medical attention immediately.

“Think FAST – Face Arm Speech Time. Is there a droop of the face? Can both arms be held up straight? Is there trouble speaking or nonsense speech? If so, time is of the essence – call an ambulance immediately,” he said.

“Prompt access to specialist stroke care in either country South Australia or metropolitan Adelaide is essential to ensure strokes are adequately diagnosed and treated.”

Under the new model of care:

Flinders Medical Centre will provide phone support to Mount Gambier Hospital and country hospitals in the Southern Fleurieu, South East and Kangaroo Island between 8am and 8pm, seven days a week;
The Royal Adelaide Hospital will provide phone or videoconference support to all other country hospitals between 8am and 8pm, seven days a week;
After-hours support (from 8pm until 8am) will be provided to all country hospitals by the Royal Adelaide Hospital