Public sector hospitals should be equipped to make optimal stroke care available to every citizen, says Padma Srivastava, Professor of Neurology, All India Institute of Medical Sciences.
Dr. Srivastava, mentor for the re-organisation of stroke care programmes in health systems under the National Programme for the Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS), was in the city recently for a programme organised by the Health department to train primary care physicians in stroke management.
There have been a lot of advances in the manner in which stroke and its outcome are managed, thanks to the advances in neuro imaging and the availability of new thrombolysing agents.
Yet, huge treatment gaps exist in the way stroke is managed in the country.
“The biggest challenge has been the mindset that only neurologists can perform thrombolysis. There are only 2,000 neurologists in the country. World over, stroke emergencies are managed by trained physicians with the help of standard operating procedures (SOPs). Neurologists should train general physicians in thrombolysis and stroke care so that more lives can be saved,” Dr. Srivastava says.
As part of the NPCDCS, she has been helping State governments lay down Acute Stroke Care Pathways, which starts with creating awareness among the public about recognising stroke symptoms and reaching a hospital quickly, to training physicians on stroke management protocols.
“We launched the programme in Himachal Pradesh (HP) in 2014. Subsequently, UP, Rajasthan, Telangana and Punjab have come on board. The HP experience has been so rewarding. It is a “hub and spoke” model, wherein 10 districts with stroke units are connected to two tertiary care centres at Shimla and Tanda. Physicians in the district hospitals use WhatsApp to communicate clinical details to the three neurologists in the State. Over 140 cases of thrombolysis have been done so far there,” Dr. Srivastava says.
Kerala, with the maximum number of neurologists in the country and well-linked hospital network and systems should gear up to meet the stroke epidemic, she feels.
“The need for physicians to get adequate training in stroke care cannot be stressed enough. Neurologists should take the lead in providing training to the physicians, while the government should ensure that the thrombolysing agent is provided free in district hospitals,” she points out.
