Wed, Nov 14, 2012 - Page 4 News List

Doctor advises advanced care planning for strokes

THINKING AHEAD:Intravenous thrombolytic treatment can greatly reduce the chances of paralysis if delivered in time, but it is often delayed by the need for consent

By Jason Pan  /  Staff writer, with CNA

Doctors are urging the public to set up their own advanced care planning to administer treatment at home for stroke victims to reduce the severity of paralysis and help boost post-stroke rehabilitation.

The recommendation was made by Shen Hsiu-chu (沈秀祝), the attending physician at the neurology department at the Chimei Medical Center at a health education seminar held in Greater Tainan yesterday.

She said immediate treatment can be effective in cases of ischemic stroke, a common type of stroke caused by an inadequate supply of blood and oxygen to the brain due to the blockage of an artery, resulting in the death of an area of brain tissue.

Shen said studies have shown that, if within three hours of the stroke, the patient receives intravenous thrombolytic treatment — the injection of plasma proteins and activators to break down blood clotting — this can speed up recovery by 33 percent and greatly reduce the likelihood of paralysis and other disabilities.

Clinical data in Taiwan indicates a low rate of intravenous trombolytic treatment for stroke victims, she said.

Statistics from Chimei Medical Center show the rate at less than 5 percent.

“The main reason is a lack of awareness of this treatment and also delays getting the stroke victim to hospital,” she said.

Shen said that for intravenous thrombolytic treatment, there is a risk of hemorrhaging, and the treatment requires the consent of the patient or family members.

In hospital, it is common to see family members in distress and unable to make a decision. In other cases, family members are working far away and can not reach the hospital in time to give consent.

Therefore she has recommended instituting advanced care planning for the emergency treatment of stroke victims.

“Many people in the US and Europe carry a personalized medical instruction card with them, which gives information on the type of medical treatment they wish to receive in the case of illness,” she said. “Thus, for persons with a high risk of stroke, they can consult with medical professionals and family members to pre-plan and decide on their healthcare and medication in the future.”

Shen said that for most people suffering from a stroke, there was a high probability of death or severe paralysis, so the best course is prevention.

She urged advanced care planning and other preventative measures for people with high blood pressure, diabetes, heart disease and those with a family history of strokes.

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