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Stroke PAST Protocol – Ken Rowe (Case Study)

Nov 26 2012

Ken Rowe

Ken Rowe is proof that HMRI funded research is changing lives in our community after the 65 year-old suffered an Ischemic Stroke.

Thanks to research funded by HMRI and the introduction of a protocol to fast-track the treatment of stroke victims, Ken was able to enjoy a remarkable recovery and returned to his family, home and livelihood.

The revolutionary Pre-hospital Acute Stroke Triage (PAST) protocol, which helped save Ken’s life, was developed by one of Australia’s leading clinical and research stroke centres, HMRI’s Stroke Research Group.

Associate Professor Mark Parsons, leader of the Research Group, says that the PAST protocol gives stroke victims the best chance of arriving at John Hunter Hospital within the vital three hour window after the first symptoms of stroke occur.

“Arriving at hospital quickly dramatically improves access to brain saving treatments including a highly effective clot busting drug,” Mark said.

“Thanks to the quick responses of his family and the paramedics who enacted the PAST protocol, Ken was delivered to John Hunter Hospital well within the three hour treatment window.”

“We were then able to meet him at the Emergency Department and identified him to be a good candidate for the treatment.”

After being administered an injection, a nurse monitored the flow of blood to Ken’s brain. Ken recalls, “I can hear her talking to Lyn and explaining what the different pulses and waves meant on the screen. She said that when the drug starts to break up the clot, we would hear a different sound.

“Within the hour I heard it, and from behind me, the nurse said ‘Lyn we’ve got him’.”

Ken was transferred from the John Hunter Emergency Department to a ward and overnight he regained consciousness, feeling and the ability to speak.

“Through the night I feel everything come back online. My jaw clicks back into place and my arms go all nice and warm,” Ken said.

“At 3:30am when the night nurse came in flashing her little pen light over my drip and looking at my charts I gave her a heck of a fright.”

“‘Good morning sister’, I said to her. ‘How are you today?’”

Ken adds that Lyn knew all about stroke, as both her grandparents had them.

“She didn’t know if I would be coming home that day, and if I did, would I be able to talk to her?” Ken adds.

“Would I be walking, carrying my granddaughters, building my model trains? Would I remember who she was?”

Ken did remember and made a full recovery as a result of the remarkable work of the HMRI Stroke Research Group.

Ken returned to his two passions, building model trains and being a model grandparent.

The Pre-hospital Acute Stroke Triage (PAST) Protocol is giving stroke patients access to world class thrombolysis or clot-busting stroke treatment.

Implementation of the program in the Hunter region resulted in an increase from 4.3 per cent to 21.4 per cent of patients receiving thrombolytic therapy, which is better than international best practice benchmarks. Of those treated, 43 per cent had minimal or no disability three months later.

The HMRI Stroke Research Group has also demonstrated that the window for administering thrombolysis could be extended to up to six hours after a stroke. This finding will benefit an additional 5,000 Australian stroke patients each year.

NSW Health has commenced implementation of the new protocols throughout the whole of NSW which will bring economic benefits as well as better health outcomes to the people who are unfortunate to suffer from a stroke.