Saving precious minutes
The LRH stroke team snapped into action in August with a fast-paced exercise designed to help shave precious minutes off responding to and treating a stroke emergency.
The Code Stroke simulation training was run by an independent assessor from the Australian Angels Initiative, which sets global benchmarks for best practice, as part of National Stroke Week.
Latrobe Regional Health stroke unit coordinator Janet May said the activity was a part of a process review to find out how the team could improve their stroke responses to expedite the best possible outcome for the patient.
“Every minute means a lot, even five minutes can save someone’s brain function and mean the difference between returning home or living in a nursing home with a disability,” she said.
“A person loses between one and nine million neurons in their brain every minute in an untreated stroke, so the quicker we act, the better the outcome.”
A professional actor played the role of “Simone Sim” who was delivered to ED by ambulance simulating a real stroke case, with slurred speech and right limb weakness.
The paramedics then handed her over to the LRH stroke team who rushed her into a radiography for series of CT scans to check for any abnormal blood flow in the brain.
“Simone” was transferred back to the ED where the treating doctor checked her hand, leg and eye coordination to test her reflexes.
The team then logged onto consult with an on-call Melbourne-based neurologist via Victorian Stroke Telemedicine, who made a decision to administer clot-busting medication.
The entire simulation took 50 minutes from arrival to medication delivery, well below the recommended 60-minute best practice benchmark.
“We are already meeting our targets and guidelines, but now we are looking at how we can cut this time even further by refining our process to give the best care we can,” Janet said.
“The idea was to simulate as closely as possible the real-life treatment and to involve as many staff as possible. Some of our junior nurses hadn’t seen a stoke code before so this was great exposure.”
Earlier this year, the LRH stroke unit won a prestigious World Stroke Organisation Angels Platinum Status Award for restoring blood-flow to the brain to eligible patients within 60 minutes of arrival.
Picture gallery: Scroll below to see what happens in a simulated stroke code.
Paramedics deliver "Simone Sim" to the LRH emergency department.
"Simone" is being delivered into the ED.
She is being transferred onto the CT table by the paramedic and ED team to undergo a series of scans.
LRH staff are observing the simulated CT from the control room.
The radiographer is securing her head into the scanner.
The ED doctor is looking at the scans to check for any mismatching blood flow. This scan was used from a real case.
"Simone" is being transfered back to the ED.
The ED doctor is updating the nurse on the latest assessments.
The nurse is checking the patient's pupil responses.
The ED doctor is checking her finger-to-nose coordination as part of a series of limb weakness checks.
The doctor is calling Victorian Stroke Telemedicine (VST) to log in to the on-call stroke nuerologist based in Melbourne.
The doctor is updating the patient and a pretend family member on the situation.
A group of observing nurses are being tutored by the LRH ED educator.
The ED doctor is liaising with the on-screen neurologist via the VST.
The VST nuerologist is carrying out his own limb checks in front of observing staff. He will then make the decision to administer clot-busting medicine and have the patient moved to intensive care.
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