'Only 12% of stroke victims getting free, speedy treatment'

[Jonathan Fairfield]

'Only 12% of stroke victims getting free, speedy treatment'

BANGKOK:-- FAST-TRACK treatment for stroke sufferers is available at many state hospitals across the country, but just 12 per cent of victims have accessed the service.

"So many patients have missed an opportunity to get free and effective treatment," Assoc Prof Dr Somsak Tiamkao of Khon Kaen University's Faculty of Medicine said, in the run-up to World Stroke Day.

The occasion is observed worldwide on October 29 to underscore the serious nature and high rate of strokes, to raise awareness about preventative measures, treatment, and ensure better care and support for survivors.

In suspected cases of stroke, Somsak stressed the importance |of calling 1669 for a free ambulance that rushes the victim to hospital.

"The faster patients get the right treatment, the greater their chance of surviving and avoiding paralysis," he said.

He said that while recombinant tissue plasminogen activator (rT-PA) - the drug used to treat stroke - costs between Bt70,000 and Bt100,000, the government provides it at no charge to Thai victims.

"No matter what healthcare scheme you are entitled to, you can get this drug for free if you have had a stroke," said the neurologist, who works at the university's Srinagarind Hospital.

He lamented that despite the free treatment, just 3.8 per cent of stroke patients had received rT-PA.

Receiving a timely prescription of rT-PA offers a 50-per-cent chance of satisfactory recovery, Somsak said.

"It's necessary that patients get diagnosed fast.

"And the stroke fast-track is offered for that purpose. Patients who seek treatment via this specially designed service will undergo a brain X-ray, a blood test, and get a diagnosis within 40 minutes."

He said stroke could hit people out of the blue, with victims often waking up to realise they have had an attack while sleeping.

"Twisted lips and weak limbs are among the symptoms associated with stroke," Somsak said.

He said to avoid stroke, people should get an annual check-up, have their chronic illnesses treated and exercise regularly.

"Avoid smoking, stress, alcohol consumption and becoming overweight," the neurologist said.

The toll on Thais

A case of paralysing stroke occurs on average every four minutes in Thailand.

Every 10 minutes, one Thai dies of stroke.


Source: http://www.nationmultimedia.com/national/Only-12-of-stroke-victims-getting-free-speedy-trea-30271524.html

-- The Nation 2015-10-25

[tigermonkey]

Is this treatment including recombinant tissue plasminogen activator (rT-PA) truly available free to all stroke victims or only to Thai citizens ?

How many areas of the country would get an appropriate rapid response by calling 1669 ?

How many of the 1300 hospitals in Thailand have have the qualified physicians in-house 24/7 to make the initial diagnosis and perform proper treatment ?

How many of the 1300 hospitals in Thailand have the necessary equipment ( eg "brain Xray" sic, laboratory) available in-house with qualified technicians 24/7, to confirm the diagnosis ?

How many of the 1300 hospitals in Thailand ( 1000 government) have rT-PA in their pharmacy ?

Are there any hospitals in Thailand which meet all of these conditons ?

While you contemplate the numbers 5 to 10, I need to tell Dr. Somsak that "you are a dreamer, and need to teach less and go out to experience the real world.

Edited October 25, 2015 by tigermonkey

[Sheryl]

Free only to Thai citizens

There are government hospitals that have these services but these would only be the regional hospitals, large teaching hospitals and the like. A good chunk of the population does nto live within reasonable distance of oen of these places.

There are private hospitals that have these facilities too but almost entirely limited to Bangkok, and care there will not be free.

I may be wrong, but I have grave doubts about a call to 1669 resulting in people being taken to the best facility for their needs...in general and also for stroke. I see "1669" written across the dodgy private "rescue vehicles" which are well known for taking people to small, poorly equipped private hospitals that give a kick back.

Hospitals all have their own ambulances. The best advice I can give TB=V members is to do some advance research and pre-select a hospital and gets its ambulance number, carry it with you and also inform friends an

[oncearugge]

Many Western countries struggle to provide appropriate "stroke care" to their populations.

Only in places like London where Emergency "stroke" care has been centralised within a few centres of excellence can treatment be optimised. Even then a high level of public awareness and the availability of well educated paramedics are required before the system will function.

The medication mentioned is not indicated for all "strokes" and access to urgent CT brain scanning, the expertise to interpret the scan and expert doctors and nurses are all required if stroke outcomes are to be improved.

[elgordo38]

Sorry to busy building a railroad to China. Please come back later.

[chilli42]

Too bad they neglected to mention that one of the most important stroke treatments is two aspirin within the first 5 minutes. This can be a life saver or contribute to a much speedier recovery. If you are in a risk group be sure you have aspirin handy in the house/car and be sure that freinds and family know to administer it to you in case you are unable. Getting to the hospital in Bsngkok is not going to be quick. Aspirin will make a big difference.

[alyx]

It is nice to hear there is a structure but the problem is not the free treatment available but the fact that the symptoms are not recognised.

Last time I checked, the Neuro in charge just let the patient off after having him waiting for a couple of hours. His conclusion was that there was nothing to do apart from prescribing painful tests to find the reason of the symptom ( mutism), tests I initially turned down but had them done a couple of days later. Anyway , it was too late

The guy eventually prescribed some aspirin, adding that things would better themselves with time.

The incompetence of this guy is now obvious to me, especially when one knows that the patient was brought to the hospital within the critical three hour time frame.

So, please, let the word out, let ( inform ) the doctors know what a stroke is and, if unable to perform the vital intervention, have them give the address of a hospital specialed in strokes ( free or not )

I am talking about a Bangkok's hospital

Edited October 25, 2015 by alyx

[oncearugge]

Too bad they neglected to mention that one of the most important stroke treatments is two aspirin within the first 5 minutes. This can be a life saver or contribute to a much speedier recovery. If you are in a risk group be sure you have aspirin handy in the house/car and be sure that freinds and family know to administer it to you in case you are unable. Getting to the hospital in Bsngkok is not going to be quick. Aspirin will make a big difference.

Dangerous advise for which authoritative links should be provided.

Until the links are provided chilli42's "advice" should be ignored.

[Srikcir]

Too bad they neglected to mention that one of the most important stroke treatments is two aspirin within the first 5 minutes. This can be a life saver or contribute to a much speedier recovery. If you are in a risk group be sure you have aspirin handy in the house/car and be sure that freinds and family know to administer it to you in case you are unable. Getting to the hospital in Bsngkok is not going to be quick. Aspirin will make a big difference.

Dangerous advise for which authoritative links should be provided.

Until the links are provided chilli42's "advice" should be ignored.

http://www.webmd.com/stroke/news/20000601/aspirin-after-stroke-helps-prevent-another

[oncearugge]

Too bad they neglected to mention that one of the most important stroke treatments is two aspirin within the first 5 minutes. This can be a life saver or contribute to a much speedier recovery. If you are in a risk group be sure you have aspirin handy in the house/car and be sure that freinds and family know to administer it to you in case you are unable. Getting to the hospital in Bsngkok is not going to be quick. Aspirin will make a big difference.

Dangerous advise for which authoritative links should be provided.

Until the links are provided chilli42's "advice" should be ignored.

http://www.webmd.com/stroke/news/20000601/aspirin-after-stroke-helps-prevent-another

That is NOT an authoritative reference / link

Did you read this ?

"Content under this heading is from or created on behalf of the named sponsor. This content is not subject to the Boots WebMD Editorial Policy and is not reviewed by the Boots WebMD Editorial department for accuracy, objectivity, or balance."

Extracted from your link which should be ignored.

Edited October 25, 2015 by oncearugge

[Sheryl]

Aspirin is helpful in strokes caused by a blood clot (which are also the type for which the treatment mentioned in the OP are used). However:

(1). There are two types of stroke, thrombotic (blood clot) and hemorrhagic (a blood vessel bursts open). Aspirin is dangerous for the second type, and it is not possible for the patient and relatives to know which type of stroke it is.

(2) Having taken aspirin may preclude use of the clot-busting drugs even if you get to a hospital able to provide it within the required time frame.

Hence, I would not advise it.

It is however advised for people having symptoms of a heart attack (provided they have no contraindications such as bleeding disorder, ulcer/gastritis or being on an anticoagulant). And it may be prescribed as a preventive for people who have had a prior thrombotic stroke or have other conditions that put them at risk.