Focus Magazine - Bradford Teaching Hospitals NHS Foundation Trust

Patient Keith Robertshaw is picturedwith Dr Hawraman Ramadan andnurse Sabina Akhtar.Picture courtesy of Guzelian.The swift action of ambulance and hospital staff has helped save thelife of a 70-year-old stroke patient who received clot-dissolving drugsjust 22 minutes after arriving at our Emergency Department.Doctors, nurses and radiographersall worked seamlessly to ensurethe 5cm clot in Keith Robertshaw’sbrain was shattered - and at 22minutes the team halved thenational average time taken athospitals which are centres ofexcellence for treating strokes.In that short time Keith, whowas paralysed down his right sideand unable to speak or see half ofhis right visual field, was assessed,had blood tests, was given a CTscan, had the scan results analysedand was administered the drug.It was also the biggest clot everseen by consultant neurologist,Dr Hawraman Ramadan whodescribed Keith’s recovery as‘miraculous.’In just 60 minutes from makingthat emergency call, he had beenrushed to hospital from his homein Sandy Lane, Bradford, and hadbeen given the drug by BRI stroketeam co-ordinator, Ian Melvin,which he desperately neededand which can only be given upto four and a half hours after thestroke.Dr Ramadan added: “Time isof the essence when it comes totreating strokes. For every minutewasted two million nerve cells inthe brain die. There are three keyparts to this story.“First Mrs Robertshaw’s swiftthinking, secondly the ambulancegetting to him quickly andwarning us he was coming in toA&E and then the A&E, stroke andCT teams working together andacting very fast.“The national average atcentres of excellence for strokesgiving the treatment he got fromus is 45 minutes but we did itin 22 minutes – we broke ourown record, halved the nationalaverage and he got the drughe needed 61 minutes after theonslaught of his stroke at home.“From a clot that size, thebiggest I have seen in thethousands of CT scans I’ve lookedat, I really did not expect thisrecovery. I had warned the familyto expect the worst.”A follow-up CT scan showedthe long clot had dissolved insidethe main artery which suppliesthe left-side of the brain withblood and Keith was back athome three weeks later, after ashort spell at St Luke’s stroke andneurology rehabilitation ward.Dr Ramadan said: “We willkeep an eye on Keith for a whileto make sure his blood pressure isunder control and advise him ona healthy lifestyle – then the ball isin his court.”A stroke can be diagnosed using FAST:Facial weakness - has the person’s face drooped, usually down one side.Arm weakness - is the person able to lift both arms above their head.Speech problems - does the person’s speech sound slurred.Time to call 999 if one or more of these symptoms are present.FOCUS August 2013 page 3