4th UK Stroke Forum: What can we do to prevent strokes
amer | Dec 07, 2009 | Comments 0
For the fourth year running the British Association of Stroke Physicians (BASP) and stroke association managed to put a comprehensive programme for the stroke forum UK. It is a good platform for the stroke physicians and stroke allied health professionals to meet and discuss the latest developments in the field of acute and post acute stroke care. For the period 1st-3rd December 09 the stroke forum was started in Glasgow/Scotland. There were hundreds of attendees to the conference and they are coming from all over the country to discuss stroke care and exchange experiences. The BASP training session was chaired by Dr. Christopher price and the learning objectives of this session were to:
-Understand safe practice during thrombolytic therapy for acute stroke
- Recognise situations and approaches to investigation of patients with rarer causes of stroke
- Appreciate the variable presentations of neurological migraine and the role of investigations
- Recognise features of dizziness which do not indicate vascular disease and further investigation
- Awareness of the current training programme for stroke medicine
In the first day of the forum, Professor Kennedy Lees from University of Glasgow, updated the audience about SITS. The aim of the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) was to assess the safety and efficacy of intravenous alteplase as thrombolytic therapy within the first 3 h of onset of acute ischaemic stroke. The avialble information confirmed that 6483 patients were recruited from 285 centres (50% with little previous experience in stroke thrombolysis) in 14 countries between 2002 and 2006 for this prospective, open, monitored, observational study.
Professor Lees mentioned that there are 93 medical centres in UK which are participating in thrombolysing stroke patients and in comparison with the rest of Europe the time to needle time is slightly longer for UK patients. Professor Lees concluded that he thinks that the process currently is moving in the right direction although he mentioned that we are still thrombolysing more severely affected patients clinically than the rest of the European colleagues.
Professor Garry Ford was discussing the issue of thrombolysing patients over 80s. He mentioned that the mortality rate for above 80 years old patients following thrombolysis after stroke is at 31% higher than the rest of the patients which stand at 14%. He pointed out that currently a hyperacute research grant is available for at least 8 stroke units in UK to enhance the thrombolysing service.
In the first day of the UK Stroke forum there was a session for the stroke nurses and the allied health professionals. In that session Dr. Anne Rowat was outlining the rational for food and fluid needs following a stroke. Dr Ailsa Brotherton was talking in the same session about the PEG feeding : patient carer perspectives.
The forum paid attention this year to the issue of stroke rehabilitation. The first training session in the forum regarding this subject was about life after stroke. The learning objectives are:
-Highlighting key issues contributing to the experience of life after stroke
- Discussing current evidence on programmes designed to support life after stroke using examples from four different programmes of research and practice development.
- Outlining the key gaps in current provision and the potential barriers to participation after stroke, incorporating the stroke survivor’s perspective.
Dr. Kate Radford from University of central Lancashire was talking about Vocational rehabilitation for stroke patients and there was another talk about getting out of the house by Dr Pip Logan. Professor Julie Bernhardt from Australia presented to the forum the latest research results regarding the timing of starting rehabilitation after stroke. She spoke about a new model for rehabilitating stroke patients. The model is combining between the acute service and rehabilitation enabling the physiotherapist and the occupational therapist to perform their tasks whilst the patient is still in acute stroke ward. She mentioned that the advice for the clinicians is to let the rehabilitation team in touch with the stroke patients as soon as it is clinically possible and the patients are haemodynamically stable. Professor Bernhardt as she is the main investigator of AVERT trail (A very early rehabilitation trial for stroke) mentioned that it is a pragmatic trial which investigate the benefit of early rehabilitation on 5 days a week basis for stroke patients. It is an international multicenter trial with few centres in England and Wales participating in recruiting patients for it.
The trainee of BASP and in the second day of the forum has presented their abstracts for their research activities. There was a presentation about inflammatory markers and poor outcome following stroke, reliability of the Modified Rankin Scale and the need for intensive cardiac monitor following a TIA.
The forum has hosted many talented people who presented their new ideas for better stroke and TIA service in their own regions. There was a good opportunity to discuss the ideas between the attendees and the exhibitors in the ideas fair in Glasgow. The forum remembers the important role of the paramedic in TIA, Stroke care. There was a presentation about extending the role of paramedics in early management of TIA and stroke by David Davis from South East Coast Ambulance Service.
