Increase in number of stroke centers, advances in treatment save more patients in Vietnam

At present, the whole country hosts about 110 stroke centers, compared to only one in the People’s Hospital 115 in Ho Chi Minh City in 2006, Assoc. Professor Nguyen Huy Thang, Chairman of the Department of Cerebrovascular Diseases at 115 People’s Hospital and Chairman of the HCMC Stroke Association, said VnExpress on the sidelines of the “Angels Academy: Stroke Multi-disciplinary” meeting held on June 25 in the city.

“It is the great effort of individuals, Vietnam and HCMC stroke associations,” Thang said.

The stroke treatment training conference co-hosted by Angles was streamed live online to stroke doctors from ASEAN, South Korea and Australia. Photo by Huy Hoang

In addition, the associations have worked with the Angels Initiative, launched by Boehringer Ingelheim and supported by the European Stroke Organization and the World Stroke Organization to improve care for people who have just suffered a stroke, organize training for doctors, Vietnamese nurses and paramedics focused on the treatment and care of stroke patients.

The initiative aims to develop more and better stroke-ready centers, and to create and grow effective regional referral networks where primary and comprehensive centers and EMS work together to provide patients with the best care.

As a result, stroke center doctors and nurses have applied more advances in stroke treatment that meet international standards to save more patients and minimize long-term disabilities caused by strokes, Thang said.

These advances include the use of recombinant tissue plasminogen activator (rtPA) which has been the standard of care for the treatment of acute ischemic stroke and mechanical thrombectomy – the type of minimally invasive procedure in which a radiologist Interventional uses specialized equipment to remove a clot from a patient’s artery.

Teacher.  Nguyen Huy Thang (second position from left) and experts discussed advances in stroke treatment at the conference.

Teacher. Nguyen Huy Thang (2nd L) and experts discussed advances in stroke treatment at the conference. Photo by Huy Hoang

In addition, several hospitals including 115 People’s Hospital and 115 Gia An Hospital in HCMC, Phu Tho Province General Hospital… and Quang Ninh Province General Hospital have used the framework RAPID artificial intelligence solution combining deep learning, machine learning and expert feature extraction. The RAPID artificial intelligence framework helps quantify brain damage and expand the potential stroke response window from six hours after onset to up to 24 hours, for patients with salvageable brain tissue. RAPID provides physicians with fast, fully automated and easy-to-interpret imaging that facilitates clinical decision-making regarding stroke.

During the period 2007-2010, nearly 100 to 200 acute stroke patients received treatment, Thang said, adding that the figure has now risen to around 10,000. doctors and nurses to help stroke patients access the best treatment that increases their chances of being free from long-term disabilities and returning to a normal life.”

“We know that 70% of stroke patients cannot function as they used to,” he added.

To improve the quality and efficiency of the treatment and care of stroke patients in stroke centers, nurses also play a vital role. Speaking at the ‘Angels Academy: Stroke Multi-disciplinary’ meeting, Do Thi Hai Van, head nurse at the Bach Mai Stroke Center, said they help doctors manage stroke patients to prevent complications, including paralysis, difficulty swallowing or speaking, balance problems, dizziness, memory loss, difficulty controlling emotions, depression, pain, and behavioral changes.

They are trained to recognize early signs of complications like a dangerous and life-threatening pulmonary embolism that results from venous thromboembolism, also known as blood clots, developing in a paralyzed lower limb after a stroke. They then show up to doctors to treat and save those patients in time, Van said.

During the treatment process and before discharge from the hospital, they spend time educating patients and their loved ones on speedy recovery, she said, adding that besides, nurses also talk to patients.

According to the World Stroke Organization, stroke remains the second leading cause of death and the third leading cause of combined death and disability worldwide.

In Vietnam alone, 200,000 new cases of stroke are recorded every year, the health ministry said, adding that strokes kill 11,000 people.

Telemedicine in stroke treatment

The Angels Academy: Stroke Multi-disciplinary meeting also highlighted the role of telemedicine in helping stroke patients, especially in remote areas without stroke centers, gain faster access to treatment. and reduce the number of false strokes. Early triage by a stroke consultant can potentially speed up “door-to-needle” times once patients are in hospital by allowing for better preparedness.

At the meeting, Dr David Hargroves, Consultant Stroke Physician at East Kent Hospital University Foundation Trust in England, shared the experiences and results of setting up a telemedicine pilot project between the South East Coast Ambulance Foundation Trust and the East Kent Hospitals University Foundation Trust in November 2018 to test the feasibility of direct pre-hospital calls between ambulance clinicians and hospital doctors to triage FAST+ patients (facial drooping, arm weakness, speech difficulties and delay in emergency call).

“Telephone triage assessment between stroke specialist and ambulance team improves sensitivity and specificity of triage to support critical access to thrombolysis and thrombectomy,” he said. declared.

Professor Ken Butcher, director of clinical neuroscience at the Prince of Wales Clinical School at the University of New South Wales, has introduced telestroke services that bring sub-specialist stroke care to hospitals rural and remote using telehealth technology.

Professor Kenneth Butcher shared the role of telemedicine in stroke counseling and treatment.

Professor Kenneth Butcher shared the role of telemedicine in stroke counseling and treatment. Photo by Huy Hoang

The service provides people living in regional and rural areas with increased access to life-saving stroke diagnosis and treatment. This is done by connecting local doctors with stroke specialists, via video consultation in the emergency department.

“This service is not expensive and could be suitable in Asia,” he said.

The meeting focused on getting better and better: how we can work together to optimize stroke systems and networks, to develop effective stroke networks and telestroke programs; and to reinforce the importance of post-acute care in improving patient outcomes. It was held as a hybrid meeting at HCMC’s Sheraton Saigon Hotel and streamed live online for stroke teams from the ASEAN region, South Korea and South Korea. Australia.

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