Paphos People

This is in addition to Pete's STROKE post earlier.

http://www.stroke.org.uk/campaigns/curr ... _fast.html


Suspect a stroke? Act FAST

One of the main aims of the Stroke is a Medical Emergency campaign is to raise awareness of the symptoms of stroke.
With over 150,000 people in the UK having a stroke every year, it is imperative that people can recognise a stroke when it's happening and take prompt action
What is a stroke?
A stroke is a brain attack. It happens when the blood supply to the brain is disrupted. Most strokes occur when a blood clot blocks the flow of blood to the brain. Some strokes are caused by bleeding in or around the brain from a burst blood vessel.
What are the symptoms of stroke?
To help people recognise the symptoms of stroke quickly, The Stroke Association has funded research into FAST - the Face Arm Speech Test - which is used by paramedics to diagnose stroke prior to a person being admitted to hospital. By diagnosing the possibility of stroke before reaching hospital, it is possible for appropriate referral to a stroke unit to be made as quickly as possible.
What is FAST?
FAST requires an assessment of three specific symptoms of stroke.
Facial weakness - can the person smile? Has their mouth or eye drooped?
Arm weakness - can the person raise both arms?
Speech problems - can the person speak clearly and understand what you say?
Test all three symptoms
If the person has failed any one of these tests, you must call 999. Stroke is a medical emergency and by calling 999 you can help someone reach hospital quickly and receive the early treatment they need. Prompt action can prevent further damage to the brain and help someone make a full recovery. Delay can result in death or major long-term disabilities, such as paralysis, severe memory loss and communication problems.
What if the symptoms go away?
A Transient Ischaemic Attack (TIA), which is sometimes called a mini stroke, is similar to a full stroke but the symptoms may only last a few minutes and will have completely gone within 24 hours. Don't ignore it. It could lead to a major stroke. See your GP as soon as possible and ask to be referred to a specialist stroke service. This should happen within seven days.

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John

In Arduis Fidelis

Excellent information John, Thank you

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Molly

Treat others as you want to be treated

Excellent John!

A friend of our's has just had a 'mini' stroke, he is fine now, but they did keep him in hospital for a couple of day's.

Good info though

Wendy.

Well it took me 2 minutes to read that,
And I could now maybe save someones life.
Well done John

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REACH 1000`s of PAPHOS CUSTOMERS EVERY DAY FOR A FRACTION OF WHAT THE OTHERS CHARGE
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Whilst the optimist and the pessimist argued that the whisky glass was either half full
or half empty ? .
I drank it .....
The opportunist..

Hi John

One thing that still concerns me is treatment once a stroke victim has been "identified" by FAST then presumably its get to hospital fast? I have heard that it is important that the ambulance service recognises that a stroke is an emergency - same severity as a heart attack - so 6 to 8 minutes is the aim. Once there then as I understand it the patient is assessed for thrombolisation (sp!!) which is the use of stroke busting drugs. If I have got anything wrong here no doubt you will put me right.

So big questions now. So do you call an ambulance in Paphos or do you stand a better chance of using a taxi? Sorry if I sound flippant but I'm not. And what hospital in Paphos is set up to assess and administer clot busters?

I am not sure that I will like the answers..........but please I would like to understand.

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Regards

John

Planet Cyprus News,

Excellent question John. I am sure we will all be interested in the answers.

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Tina
xxxx

By the book call an Ambulance, unoffially use your car, however bear in mind the chance you will be taking if the person fits, or worse when you are on the move, in an enclosed space etc.

Now if you go to the web site on my profile you may find a better answer.

Even e mail, as you never know who is browsing, I will say things are going to change very soon, and if the NEW/old HEALTH MINISTER gets his act to-gether and puts Paramedics in the organogram of registered medical qualifications we can go on the road to-morrow, without waiting for the back up from ANY hospital.

I have 10 Paramedics, 15 drivers all waiting for the go ahead, everyone is well qualified and experienced in what they do.

The Operational Plans are in place, shift patterns, training, area orientation and so on.

Our ambulances have Defibs/suction/scoop stretchers/spine boards/oxygen/resus bags and much more.

MOST IMPORTANTLY WE HAVE THE STAFF TO USE THEM CORRECTLY

Other vehicles will arrive when I can afford them, hope to include specialised items on these such as an incubator, another would be for Patient Transport for appointments, wheel chair ramp etc we already have an ex UK driver whose job was just this.

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John

In Arduis Fidelis

Hi John

Thanks for the update and good luck !!

I think that you missed part of my question? Does any hospital in Paphos have the clot buster drugs and the expertise to use them? I also believe that a Doppler (machine) is a necessary in the treatment of strokes?

Looking forward to your update.

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Regards

John

Planet Cyprus News,

I have not seen or heard of any Hospital having Clot busters, we have them here, and the cost may be a factor in who has them elsewhere, and the shelf life is not long.

They do not use Entonox in A&E or ambulances either, only in Operating Theaters.

When I checked one place they had ampoules of 1:1,000 Adrenaline for Cardiac Arrest, it should be 1:10,000, the former being for Anaphylactic shock, and we now use mini-jets, not wasting time drawing up with syringes.

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John

In Arduis Fidelis

John,

I have to admit I'm very impressed with not only your knowledge, as thats your job but with how you've got all this set-up mate, its comfitting to know that you're out there, at the end of a phone just incase you're needed

I hope you get whatever permits & acceptance you need mate because from what little I know about the Cypriots heath service, I know they don't have the sort of equipment & ability needed to do what it is you're doing

Good on you

I have nothing on doppler for applying clot busters, they are used mainly for checking/changing blood flow

Clot-busting (thrombolytic) drugs

Do they work?

Yes. If you have a heart attack, clot-busting drugs can save your life. They work best if you get them as soon as possible after your heart attack (within a few hours of your first symptoms). They not only improve your chances of living through a heart attack, they also reduce your risk of dying from heart problems later. All the drugs in this group seem to work equally well.
Doctors call clot-busting drugs thrombolytics or thrombolytic drugs.

As their name suggests, clot-busting drugs break up blood clots. If you've had a heart attack, doctors use these drugs to dissolve the clot that caused it.
Doctors inject these drugs directly into your bloodstream, usually through a tube in one of the veins of your lower arm. For some of these drugs, you only need one injection. With others, you may be put on a drip (also called an IV or intravenous) for an hour or so.
Here are some examples of thrombolytic drugs (with brand names in brackets).
• alteplase (tissue-type plasminogen activator) (Actilyse)
• reteplase (Rapilysin)
• streptokinase (Streptase)
• tenecteplase (Metalyse)
You might get another drug, called heparin , along with or after treatment with a clot-busting drug. Heparin is a 'blood-thinner', which means it stops blood clots forming. Doctors have thought that adding a blood-thinner to a clot-busting drug might be better than just using a clot-buster.
Treatment with heparin may last just a day or two, or until you leave hospital. There are two types of heparin: unfractionated (or standard) heparin and low-molecular-weight heparin (or LMWH).
If you've had a heart attack, getting clot-busting drugs can:
• Increase your chances of surviving your heart attack.
• Increase your chances of being alive 12 years after your treatment.
You can take these drugs as long as 12 hours to 18 hours after a heart attack and they'll still work. But they work better if you take them earlier.
All the clot-busting drugs seem to work as well as each other.
Clot-busting drugs:
• Work for all types of heart attacks
• Can help people who have diabetes or who have had heart attacks before
• May be more helpful to people who have damage to the front of their hearts than to people who have damage to the back or base of their hearts.
Getting a type of blood-thinner called heparin after being treated with a clot-busting drug can reduce your chances of having another heart attack in the next 30 days.
The LMWH enoxaparin seems to work better than unfractionated heparin.
But your chances of surviving a heart attack may not be as good with a clot-busting drug as they are if you have an operation to clear your arteries. This may only be the case, however, if you're treated by experienced surgeons, or if you can't take clot-busting drugs for some reason, say because you're older and at risk of having a bleed in the brain. Also, you need to have this operation quickly (as soon as possible after you get to hospital), and this may not always be possible.
Why should they work?
Thrombolytic drugs work by attacking fibrin, the substance in your blood that keeps a clot together. Once a clot-busting drug gets into your bloodstream, it takes just a few seconds to reach your coronary arteries. The drug then starts dissolving the clot that is blocking your artery. This lets blood flow to your heart again.
Blood clots cause heart attacks by blocking one of the blood vessels that supply your heart with blood. Clot-busting drugs are also called fibrinolytic drugs because they break up fibrin, the main substance in blood clots.
If the blood supply to part of your heart is cut off, your heart muscle in that area will die within six hours. Clearing the blockage quickly means that your heart will have less damage. If the damage is limited, you're less likely to have dangerous complications, such as heart failure or an abnormal heartbeat. This may explain why clot-busting drugs reduce your risk of dying straight after a heart attack and why they help patients who have had a heart attack live longer.
Heparin is sometimes used along with, or after, a thrombolytic drug. It stops clots forming. Doctors think that giving heparin to people after they have had a treatment with a thrombolytic drug will help to keep the blood vessels clear of clots and reduce the chances of another heart attack.
Clot-busting drugs can have serious side effects. If it's at all possible, discuss them with your doctor before treatment. The two main side effects are:
• Strokes
• Bleeding.

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John

In Arduis Fidelis

I have to post this simply because of my experience with my Mum.

My Mum couldn't have a thombolytic as it would have put her at too much risk of other life threatening problems.

In my case I knew what information to give the doctor to stop them from using a thombolytic, but that was only because I had the knowledge from my job.

Are you saying you have a doctor on hand at Houston Medical, John, or do you have a designated clinic you would take the patient to?

Verity.

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Verity.

Be who you are, and say what you feel, because those who mind don't matter, and those who matter don't mind.

http://coecyp.blogspot.com

When I say here, it is in my sick bay, we are all trained to administer if required offshore and in discussion with our onshore support.

We could not afford to buy them even if available in Cy, £650 for one, thats what we are charged.

I will certainly enquire on my return, however when on a med cover for the CY challenge the doctor had not intubated in an outside environment, so I am sure they don't have them in all hospitals if any, and as stated before, not using mini-jets either.

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John

In Arduis Fidelis

Thanks for clarifying that, John. I thought you were talking about your business in Cyprus. Administering medication is different from initiating the decision as to what medication should be administered.

I can appreciate that in positions where we are aligned to the medical profession we often know what the decision will be. We just have to acknowledge that we don't have the in-depth understanding that a doctor has been educated for to see the bigger picture.

Otherwise we would be doctors and not nurses, midwives, paramedics etc.

Working in our professions means working in an autonomous manner, and it is sometimes frustrating to have to wait for a doctor to tell us to do what we know we are going to be told to do. But in Cyprus it seems even more frustrating, as at least the professional accountibiliy lies with each professional in the UK. Here it seems to lie solely with the doctor, which is why it is so hard to influence change. They don't seem to realise that there is no I in T.E.A.M.

I have some highly specialised skills and knowledge. In Cyprus they are worth nothing. I find that quite sad. More so for the women who could benefit from being cared for by a midwife, than for myself.

There. Got that off my chest. It is just extremely frustrating when you know you can do a good job and you are being held back.

Verity.

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Verity.

Be who you are, and say what you feel, because those who mind don't matter, and those who matter don't mind.

http://coecyp.blogspot.com

Oh I know that feeling all too well

I so know where you're at, Verity...here there is absolutely no rehab going on, either in or outside of hospital (apart from the odd bit of physio) and its such a huge gap in a healthcare system!
All that preventative work around falls, all that follow up treatment after stroke/heart attacks etc, all the work to maintain independence when living with a long term illness.. Nothing. It frightens me.
And people think that their private insurance will cover them for everything...not if there aren't any therapists to do it!
But here i cannot afford to work. If i worked i'd have to be on the books as i'm registered with the Health Professions Council. So would therefore have to pay tax and social insurance up front. There is no pro rata scale for these if you are part time and with two small kids i have no intention of working 50 hours a week just
to pay my tax bill /nursery fees. Luckily hubby's job covers the bills - but i can't help feeling what a waste of skills/training!!
rant over...
lisa