Kerala

Stroke care amid Kerala’s pandemic management

Neurologists have called for a reorganisation of various aspects of stroke treatment and rehabilitation in the State to overcome the challenges posed by COVID-19 to stroke management and to provide better outcomes for patients.

On World Stroke Day that falls on October 29, they have highlighted the importance of maintaining the continuum of care for stroke patients even in the midst of the pandemic. The public should be encouraged to seek timely treatment for stroke while also ensuring that public health systems have better care strategies in place to give optimum care for stroke patients.

While time is the essence in stroke care, during the past few months, delays in seeking timely care, especially in the case of people who suffer minor strokes or transient ischemic attack (TIA), has been well-documented.

Screening time

However, on top of this, the time taken for screening patients through a COVID gateway, testing and donning of Personal Protective Equipment (PPE) etc. has been creating further delays at hospitals, pushing up the door-to-needle time (DNT or the time from presentation of patient with symptoms at the hospital to the start of clot-lysing treatment) beyond the recommended 30-40 minutes.

“In the event of a stroke, accessing timely care is more important than the risk of possible exposure to COVID-19. Comprehensive stroke care centres like ours have now put in place new protocols so that the DNT is well-maintained and acute care is not compromised,” says P.N. Sylaja, Professor of Neurology, who is heading the comprehensive stroke care programme at Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).

A study conducted in 13 major stroke care centres in the country, including the SCTIMST, on the changes noted in acute stroke care following COVID-19 has reported on overall reduction of about 61.22% in the reporting of weekly stroke cases. Intravenous thrombolysis and endovascular procedures were also severely affected, with an overall reduction of 64.76% and 67.21%, respectively.

Stroke rehabilitation

“Stroke rehabilitation is the key to bringing stroke victims back to normal life but this has been significantly affected during COVID-19 as home physiotherapy is not working out, neither patients nor physiotherapists are willing to take risks. This has resulted in sub-optimal results for patients. We have now started tele-rehabilitation services, mostly speech therapy and tele-consultation services for follow-up of patients,” Dr. Sylaja says.

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Printable version | Nov 28, 2020 10:45:42 PM | https://www.thehindu.com/news/national/kerala/stroke-care-amid-statespandemic-management/article32969200.ece

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