Every second of a stroke patient is precious. This is because, regardless of the condition they are in, if their treatment is late by even a fraction of a second, they might develop paresis or paralysis or permanent disability for life. Therefore, every step of treatment has to be ready and on-time. Today, we are going to take you to meet with the “Avengers Team” that provides care for stroke patients at Phyathai 2 Hospital to see the roles and responsibilities of each department within the team.
Neurologist and Neurosurgeon Team
In principle, stroke patient care requires the expertise of neurologists, neurosurgeons and interventionists in examining the patient’s history and physical condition and diagnosing the disease and making treatment plans, along with treatment follow-ups, and they have to make ongoing treatment plans with the IME multidisciplinary team. Patients have to reach doctors within 4.5 hours after onset of symptoms for best treatment outcomes.
Nursing and Ambulance Team
As mentioned earlier that every second is precious, when a stroke patient arrives at the hospital, the patient has to be transferred to the emergency department as soon as possible and safely according to standards. The nursing and ambulance team will quickly make contact and coordinate preliminary symptom assessment. If the patient’s symptoms meet the criteria, the team will transport the patient and provide care while swiftly delivering the patient to the emergency department in order to undergo treatment according to standards.
Brain and Neurology Ward Nurses
Once the patient is transferred to the Brain and Neurology ward, a nursing specialist will perform a preliminary assessment of the patient once again in order to plan nursing and care according to inpatient nursing standards and will provide information to the patient or relatives about the care and practice guidelines for acute stroke patients in addition to monitoring patient complications and assessing swallowing ability to prevent risk of choking. They will also assess the patient’s mental health and coordinate with the multidisciplinary team in order to provide knowledge and encouragement to the patient and their relatives.
Physical Medicine and Rehabilitation for Acute Hemorrhagic Stroke
After a neurologist or neurosurgeon has assessed that the patient can begin undergoing physical rehabilitation, the rehabilitation medicine team will work together with physical therapists and speech therapists to seek a suitable treatment guideline for the patient.
Physiotherapist
Rehabilitating the body through physical rehabilitation requires correct rehabilitation knowledge and advice, so a physiotherapist will provide explanations to relatives and the patient about how to exercise and practice sitting, standing and walking in addition to how to use appropriate walking devices. The patient will also be assessed for knowledge and ability to perform daily activities and receive appropriate ongoing planning according to the patient’s condition.
Occupational Therapist
For patients with swallowing difficulty or choking, an occupational therapist must be present to assess swallowing capability along with brain function related to cognition, memory, perception, sensation and fine motor control in order to plan physical therapy activities and provide knowledge and recommendations about rehabilitation to the patient and their relatives.
Speech Therapist
As for patients suffering from speech and communication problems, a speech therapist will help assess and provide rehabilitation according to the unique characteristics of each patient by correcting speech deficiencies and oral organ function along with promoting behavior modification and providing advice to guardians, relatives, caregivers and related persons.
Pharmacist
The roles and responsibilities of the pharmacist are no less important that other teams. This is because the pharmacist has to work together with medical and nursing teams to inspect and create a record of existing medications in addition to examining the patient’s history of cooperation in taking medications and history of drug or food allergies. They are also responsible for monitoring and ensuring that the patient receives their medications according to the acute stroke treatment plan in the case of the stroke alert team. In addition, the pharmacist also has to review the patient’s history to assess indications, contraindications, dosages and guidelines on how to administer intravenous rt-PA and to monitor safe medication use and provide knowledge and recommendations about medications and potential side effects to the patient and the patient’s caregivers.
Dietitian
The work processes of the dietitian are to specify what foods and nutrients the patient should receive based on the patient’s condition in order to ensure good health and the most suitable diet to the person. As for working together with the patient, the dietitian will assess and monitor the patient’s nutritional status and plan nutritional therapy and provide appropriate dietary recommendations and appropriate practices in the hospital and at home, not to mention monitoring results and making plans with the multidisciplinary team.
OPD Neurology Nurse
Upon arriving at the OPD neurology nurse, an initial assessment will be performed on the patient, followed by a repeat assessment and nursing planning to provide nursing care according to the outpatient nursing standards. The nurse will announce the stroke team code alert when the patient fits the criteria for receiving acute stroke patient care. The patient will be assessed also for knowledge and understanding and be monitored for treatment outcomes, and the nurse will coordinate with the multidisciplinary team about patient treatment planning after the patient arrives to see the doctor according to appointment for the first time.
Nurse Case Manager
For the work processes of the nurse case manager, the nurse case manager will provide guidelines and coordinate with the team to ensure consistent patient care according to the stroke patient care guidelines in addition to visiting the patient after initial history evaluation and preliminary assessment in order to make plans together with the multidisciplinary team to provide patient care covering every dimension in line with the clinical pathway. As for alerting the stroke team, the nurse case manager plays a role in managing and coordinating work among the doctors, multidisciplinary team, patients and relatives in addition to reviewing processes and outcomes in order to improve patient care processes.
Furthermore, in addition to each team that has been discussed, stroke treatment processes still involve many other personnel such as the therapeutic radiologist, technical radiologist or medical technicians. All of these individuals are highly experienced experts, so you can have confidence that after seeking treatment for stroke at Phyathai 2 Hospital, the patient will receive good treatment according to standards by the stroke Avengers Team that are ready to provide round-the-clock care and treatment, including calls to ask questions or to request for an ambulance by dialing 1772.
