Australia sets the standard in stroke treatment and care

Sep 6 2017

Associate Professor Coralie English

Australian stroke patients are set to receive the latest and world’s best stroke treatment and care following the launch of new Clinical Guidelines for Stroke Management at Parliament House.

Minister for Health the Hon Greg Hunt MP officially launched National Stroke Week and the new Guidelines on September 1, 2017.

Minister Hunt said the Guidelines made break-through clot retrieval stroke treatment standard for Australian stroke patients.

“All Australians deserve world class health care,’’ Mr Hunt said.

“Our researchers played a key role in the development of disability reducing endovascular clot retrieval – or thrombectomy – treatment, so it is fitting we adopt it as standard treatment for appropriate stroke patients. 

“The Turnbull Government is proud to support research and innovation through the Medical Research Future Fund, with the objective of improving the health and well-being of Australians.”

The development of the Guidelines was an extensive process that took two-years, involved almost 100 health professionals and researchers across 21 different healthcare disciplines. A total of 109,620 research abstracts were reviewed from Australia and internationally.

University of Newcastle (UON) stroke researcher Associate Professor Coralie English was co-chair of the Content Development working group, overseeing the project.

“It was an honour to be asked to participate in this project, and it’s fantastic to see the project finally launched,” Coralie said.

The final Guidelines encompass 250 recommendations for stroke treatment and care across the heath care continuum; starting in the ambulance and progressing through hospital, rehabilitation and the transition home.

“We’ve moved to an online platform with the new guidelines,” Coralie adds. “This means we can put a lot more detail into the guidelines and offer greater transparency. It also means that we can have the capacity to move to a “Living Guidelines” model which will allow for rapid updates when new research is released.”

Stroke Foundation Chief Executive Officer Sharon McGowan said the release of the updated Guidelines was an important step forward in improving the treatment and care of all Australian stroke patients.

“This year alone Australians will experience more than 56,000 strokes – that’s one stroke every nine minutes,’’ Ms McGowan said.

“Advancements in stroke treatment and care mean stroke is no longer a death sentence for many, however patient outcomes vary widely across the country depending on where people live.

“We now know what ideal stroke treatment and care looks like. We must focus on giving all patients’ access to it, in particular those living in regional Australia where stroke is having its greatest impact.”

Stroke Foundation Clinical Council Chair Associate Professor Bruce Campbell said the Guidelines would be the first in Australia to be developed and published on a digital platform accessible on smartphone, tablet and desktop.

“Evidence based clinical guidelines are key to establishing effective, high quality, consistent and safe healthcare practices and policies,’’ A/Professor Campbell said. 

“Traditionally, clinical guidelines have been voluminous, text-book-like documents, this new innovative model makes it easier for clinicians to identify a guideline, obtain the guideline, and then locate and understand the required information within it.

“It will improve patient outcomes and reduce costs to the health system.” 

Key changes to the Guidelines included:

  • Education of GP reception staff in the FAST signs of stroke so that they call triple zero immediately at the first sign of a stroke.
  • It is no longer recommended to get patients up and moving within 24 hours of stroke onset, however all stroke patients should be moving within 48 hours.
  • All acute stroke services should implement standard protocols to manage fever, glucose and swallow difficulties in stroke patients.  Managing these early has shown improved outcomes for stroke patients up to 4 years after their stroke.
  • Endovascular thrombectomy - or clot retrieval - is now standard care for appropriate patients. We need to ensure the health system changes to make this treatment accessible to all.
  • The minimum amount of scheduled rehabilitation therapy for stroke survivors is now three hours a day – a threefold increase from the previous guidelines.
  • Comprehensive discharge care plans which address the specific needs of the stroke survivor should be developed in conjunction with the patient and carer prior to discharge. This will help equip patients with the tools and support they need to continue their recovery journey and live well after leaving hospital.

Ms McGowan said the first step in ensuring all Australians have access to world class stroke treatment was educating every household on the signs of stroke and to call triple zero.

“This National Stroke Week we are asking all Australians to think F.A.S.T and act FAST at the first sign of stroke,’’ she said.

“Stroke is treatable, however, paramedics, nurses and doctors can only help if people recognise the signs of stroke, dial triple zero and get to hospital quickly.”

FAST stands for:

  • Face - Check their face. Has their mouth drooped?
  • Arms - Can they lift both arms?
  • Speech - Is their speech slurred? Do they understand you?
  • Time is critical. If you see any of these symptoms Act FAST and call 000 immediately.

National Stroke Week is the Stroke Foundation’s annual awareness campaign encouraging Australians to take action to prevent and be aware of stroke. Around the country community groups, hospitals, pharmacies, workplaces and individuals take part. Activities include information stalls, morning teas, talks from stroke survivors, health checks, personal or team challenges, and fundraising.

For more on the Clinical Guidelines for Stroke Management