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Before watching the video:

1. What do you know about sepsis and how it's typically treated in a hospital setting?

2. Have you or someone you know ever experienced sepsis? If so, what was your/their experience like?

3. What do you think are some common signs and symptoms of sepsis that healthcare providers might look for when diagnosing the condition?

After watching the video:

1. What did you learn about the treatment of sepsis that surprised you the most? Was there a specific aspect of treatment that you didn't know about before watching the video?

2. How does the information presented in the video change your understanding of sepsis and its treatment? Are there any new insights or takeaways that you'll remember?

3. Are there any specific questions or concerns you have about treating sepsis after watching the video? Are there any areas where you'd like to learn more?

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Before watching the video:

1. Have you ever had or seen a severe allergic reaction or known someone who has? How did they respond to the situation?

2. What do you think might cause someone to have a near-fatal allergic reaction, and how would you react in such a situation?

3. Do you think that medical technology and treatment options have improved significantly over the years in terms of treating severe allergic reactions?

After watching the video:

1. What was most surprising or inspiring to you about Antoinette's recovery from her near-fatal allergic reaction? Was there a particular moment or experience that stood out to you?

2. How does Antoinette's story make you think about the importance of being aware of food allergies and taking precautions to avoid severe reactions? Would you change any habits or practices as a result of hearing her story?

3. What do you think is the most important takeaway from Antoinette's experience, and how might her story be relevant to your own life or relationships with others who may have allergies?

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Antoinette’s Story: Amazing Recovery After Near-Fatal Allergic Reaction

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Here are some questions based on the ECG tracing of a patient with Myocardial Infarction (MI) or Acute ST-Elevation Myocardial Infarction (STEMI):

Scenario 1: ECG of a patient with Myocardial Infarction (MI)

1. What is the abnormality seen in the ECG tracing that suggests myocardial infarction?

a) Abnormal Q waves

b) ST elevation

c) ST depression

d) T wave inversion

2. Which of the following areas of the ECG tracing is most commonly affected in MI?

a) Lead I

b) Lead II

c) Lead III

d) V1-V6

3. What is the clinical significance of ST elevation in leads V1-V6 in this ECG?

a) It suggests a left ventricular hypertrophy

b) It indicates a right ventricular infarction

c) It suggests a myocardial infarction in the anterolateral wall of the left ventricle

d) It indicates a pericarditis

Scenario 2: ECG of a patient with Acute ST-Elevation Myocardial Infarction (STEMI)

1. What is the typical location of ST elevation in STEMI?

a) Leads I and II

b) Leads V1-V4

c) Leads II, III, and AVF

d) Leads V5-V6

2. What is the main indication for primary percutaneous coronary intervention (PCI) in this ECG?

a) Presence of Q waves

b) Presence of T wave inversion

c) Presence of ST elevation > 2 mm in leads V1-V4

d) Presence of bradycardia

3. What is the clinical implication of not treating STEMI promptly with reperfusion therapy?

a) The patient will likely have a good outcome without treatment

b) The patient will require prolonged hospitalization

c) The patient will likely develop cardiac arrhythmias

d) The patient will develop cardiogenic shock

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Before watching the video:

1. What are the main causes of brain stroke?

2. What are the common symptoms of a brain stroke?

3. How can brain stroke be treated?

After watching the video:

1. What is the most common type of stroke, according to the video?

2. What is the role of timely medical treatment in reducing stroke damage, as mentioned in the video?

3. What is the importance of recognising early warning signs of a brain stroke, as emphasised in the video?

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Brain Stroke, Types of, Causes, Pathology, Symptoms, Treatment and Prevention, Animation.

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Brain Stroke, Types of, Causes, Pathology, Symptoms, Treatment and Prevention, Animation.

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Before Watching the Video:

1. What are some common symptoms of psychosis that Mary may have experienced?

2. How does psychosis typically affect a person's daily life and relationships?

3. What are some potential treatment options for psychosis, and how effective are they?

Now watch the video

After Watching the Video:

1. How did Mary's experiences with psychosis impact her daily life and relationships, as depicted in the video?

2. What specific treatment approaches did Mary use to recover from psychosis, and what were the challenges she faced during this process?

3. What message of hope and resilience do you take away from Mary's story, and how can it be applied to one's own recovery journey?

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What is Sepsis?

How many types of sepsis can you find?

What is the signs and symptoms of sepsis?

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Definition:

Signs and Symptoms:

Treatment Plan

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Use the link attached to the picture to find more information.

1. What is a stroke?

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Use the link attached to the picture to find more information about delirium.

1. What is delirium?

2. What are the signs and symptoms of delirium?

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How is delirium diagnosed?

It's really important that a person's delirium is diagnosed quickly. Delirium is a serious condition and is linked to severe problems if it isn't treated.

A healthcare professional such as a doctor or nurse will make the diagnosis. To decide if someone has delirium or not, they will consider the person's clinical history (how their symptoms developed) and examine them. They will use a quick test known as a 4AT.

The 4AT test measures someone's:

alertness - whether the person is drowsy or agitated

awareness - for example, of the current year and where they are

attention - for example, how well the person is able to name the months of the year backwards from December

acute change or fluctuating course - whether symptoms started suddenly or are now coming and going.

A doctor or nurse may assess someone's mental state each day in hospital. Or they may do so when the person moves from one place to another, for example from a hospital to a care home. If they find that the person has delirium, they should tell the person's close family.

Health or social care staff involved in their care might suspect that the person has undiagnosed dementia, but will not assess them for this until their delirium is over. If they are in doubt, they will treat the delirium first as this needs treating more urgently.

Even in hospital it can be difficult for delirium to be spotted and diagnosed. This is another reason to tell staff if you notice a change in the person you care about.

As well as diagnosing the person's delirium, healthcare professionals will do other tests to work out what has caused the delirium. For example, they may take blood samples or possibly a chest x-ray. This is important because treating the cause of the delirium will usually help the person's symptoms improve or go away.

Who gets delirium and why?

Delirium is common, particularly among older people in hospital. It's usually the reaction of the brain to a separate medical problem (or several medical problems at once). Problems that can cause delirium include:

pain

infection

poor nutrition

constipation (not pooing) or urinary retention (not peeing)

dehydration

low levels of blood oxygen

a change in medication

abnormal metabolism (for example, low salt or blood sugar levels)

an unfamiliar or disorientating environment.

Anyone can get delirium, but the following factors put people at higher risk:

dementia - this is the biggest single risk factor for delirium

aged over 65

frailty

multiple medical conditions

poor hearing or vision

taking multiple medications (for example, antipsychotics, benzodiazepines and certain antidepressants)

having already had delirium in the past.

Delirium is common in older people in hospital, because they are unwell or may have had an operation (for example, hip or heart surgery). Hospital staff should speak to the patient and family beforehand about the risk of delirium after the operation. Intensive care is another very common cause of delirium in hospital.

Delirium is also quite common in residents of care homes, or in older people with dementia at home. They are more likely to be frail, have several health conditions and be taking several medicines.

When someone goes into hospital or a care home, it's helpful if they have a completed or updated copy of a form such as This is me with them. Care staff can refer to this for information about the person, which will be particularly helpful if they get delirium during their stay.

With the right care, some cases of delirium can be prevented. Soon after a person comes into hospital or long-term care, staff should check whether they are at risk of delirium. If they are, there are non-drug approaches to help prevent delirium that should be put in place, including those described below.

What is treatment and support for delirium?

Delirium is treated first by addressing the medical problem(s) that have caused it. For example, if the person has low blood oxygen or low blood sugar levels these will be corrected quickly. If the person has an infection they may be given antibiotics. If they are in pain, constipated or not passing urine then these will be treated.

Doctors will also review the person's medication and stop any non-essential drugs that may be linked to delirium. Staff will make sure the person is supported to eat and drink regularly.

Delirium will usually improve if its cause is found and treated.

A supportive and calm environment can also help someone recover from delirium. Nursing staff, and visiting family and friends, can all help by:

talking calmly to the person in short clear sentences, reassuring them as to where they are and who you are

supporting the person with familiar objects from home, such as photographs

making sure that any hearing aids and glasses are clean and working and that the person is wearing them

setting up a 24-hour clock and calendar that the person can see clearly

helping the person develop a good sleep routine, including reducing noise and dimming lights at night

reassuring the person if they have delusions

supporting the person to be active - to sit up or to get out of bed - as soon as they safely can

helping the person to eat and drink regularly

not moving the person unnecessarily - either within and between hospital wards, or into hospital if delirium is being managed at home.

Doctors won't normally give someone medication to treat delirium, because there is very little evidence that drugs help. Drugs should be considered only if the person's behaviour (for example, severe agitation in hyperactive delirium) poses a risk of harm to themselves or others, or if hallucinations or delusions are causing the person severe distress.

In either case a doctor may try a low dose of a sedative or an antipsychotic for a few days. (Doctors won't give an antipsychotic to a patient with Lewy body dementia, because of the risk of side effects.)

After delirium

The symptoms of delirium get better in most people over a few days to weeks, once the underlying cause is treated. However, delirium usually means a person will have to stay longer in hospital. When they do leave, their medical notes and their care and support plan should record their delirium and include what further support they will need.

Although some people recover fully, delirium can also have lasting consequences after it has been treated. These are more common in older people.

A person may have distressing memories of delirium, sometimes linked to feelings of fear or anxiety, for months afterwards. Those close to the person should support them to talk openly about their experience and feelings. If they've kept a diary of the person's time with delirium, they can use this to help the person make sense of their experience once they're getting better.

Delirium is linked to a faster worsening of a person's mental abilities and function. A person with dementia may have been able do something (for example, dress themselves) before delirium but are no longer able to afterwards. This change can be permanent. Some people who have had delirium will now have additional needs which are best met by them going into a care home.

In some cases a person will not have a diagnosis of dementia when they go into hospital, but after having delirium their symptoms will get worse and they will later be diagnosed with dementia. In these cases the delirium seems to have 'uncovered' the person's dementia.

These complications are more likely after delirium but they're not inevitable. However, they do mean it's important to be aware of delirium and try to prevent it where possible.

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Delirium - symptoms, diagnosis and treatment

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Delirium is a common, serious but often treatable condition that starts suddenly in someone who is unwell. It's much more common in older people, especially those with dementia.

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Delirium is common, particularly among older people in hospital. It’s usually the reaction of the brain to a separate medical problem (or several medical problems at once).

What problems that can cause delirium?

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What is treatment and support for delirium?

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What is treatment and support for delirium?

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Jack is a 72 year old male admitted to your ward. He had his hip surgery this morning.
He has T2DM, hypercholesterolemia and has had recurrent falls at home. Last week he broke his hip and was admitted for a hip replacement. He uses glasses and hearing aids in both ears. The hearing aids have no battery. The glasses are in the bedside table. He hasn't seen his wife and son for a few days and is constantly asking about them.
Since the surgery Jack has been complaining of a lot of pain. The nurses have been giving regular paracetamol and ibuprofen but it seems to not be very effective.
Jack also complains of abdominal plain and is a bit restless. The nurse is not sure weather Jack has passed urine.

1. What are the risk factor for Jack to develop delirium?

2. How could we avoid it from happening?

3. A supportive and calm environment can also help someone recover from delirium. Nursing staff help by:

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Post op PE

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How would you describe a medical emergency? 

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How would you describe a medical emergency? 

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What are the signs and symptoms of an stroke?

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Discover the causes and symptoms of a stroke, which occurs when the blood supply to part of your brain is cut off, causing brain damage.

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Read the article attached to the picture above and draw some main points.

Discuss in small groups what would you take from this article and how would you change your own practice based on this:

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Hospital-acquired delirium is a common and dangerous condition that often goes unnoticed and untreated, an oversight that experts in geriatric medicine say is costing the health care system untold millions of dollars.

"Delirium is often under-recognized and underdiagnosed," says Dr. Roger Wong, president of the Canadian Geriatrics Society. "Many patients, when they come to a hospital, they enter through the emergency department. That is their portal of entry. That is their first stop. The emergency room is a very busy place with a high turnover. It's not an ideal place for recognizing, let alone treating, delirium."

The condition, a temporary but severe form of mental impairment that can lead to longer hospital stays and negative long-term outcomes, is commonly acquired by elderly patients in acute care settings. Up to a third of patients 70 years old and above experience delirium, and the rate is much higher for those in intensive care or undergoing surgery. Until recent decades, hospital-acquired delirium, which typically lasts anywhere from a couple of days to several weeks but can even last months, was chalked up to old age and not considered a condition to be prevented or treated.

"A decade or maybe 20 years ago, people would say that it's an old person and of course they are confused," says Dr. Angela Catic, a geriatrician and instructor of medicine at Harvard Medical School in Boston, Massachusetts. "That was delirium but everyone accepted it as the norm. Well, it is common, but it's not normal."

There is no single factor that brings on delirium. People who already have dementia or are particularly frail are at higher risk of acquiring the condition. Once in hospital, delirium can be caused by a combination of numerous factors, including surgery, infection, isolation, dehydration, poor nutrition and medications such as painkillers, sedatives and sleeping pills.

"Besides age, drugs are probably the number one factor, but delirium is always multifactorial," says Catic. "We cannot say it is due to any one factor."

The short-term effects of delirium can differ from patient to patient. The primary symptoms are shifting attention, poor orientation, incoherence and poor cognition. Most patients who acquire it must subsequently spend extended periods of time in expensive acute care settings. Some who suffer from the condition experience hallucinations and become aggressive and belligerent. Others, however, become sleepy and lethargic, their silence making the delirium more difficult to detect. Testing for the condition should occur several times a day, as symptoms frequently come and go.

"Fluctuation is a hallmark of delirium," says Catic. "It will wax and wane."

In the long term, delirium can cause permanent damage to cognitive ability and is associated with an increase in long-term care admissions. It also leads to complications, such as pneumonia or blood clots that weaken patients and increase the chances that they will die within a year.

"Delirium is an emergency. It is a serious medical problem," says Dr. Kannayiram Alagiakrishnan, an associate professor of geriatric medicine at the University of Alberta in Edmonton. "If it's not treated and not addressed rapidly, it can lead to increased morbidity, increased mortality. Patients will stay in the hospital for a long time and may have some functional decline."

Alagiakrishnan is the lead author of a study that concluded health care professionals are not doing enough to identify the predisposing and precipitating factors that lead to delirium, a sentiment echoed by many in the field of geriatric medicine ( Can Fam Physician 2009;55:e41-6). The study assessed 132 patients ages 65 and older who were admitted to medical teaching units at the University of Alberta Hospital over a seven-month period and found that 20 of those patients, or 15.2%, developed hospital-acquired delirium.

"The focus is often on physical problems in hospitals and the mental side is not properly assessed," says Dr. Martin Cole, a geriatric psychiatrist at St. Mary's Hospital Center in Montréal, Quebec. "Some sort of systematic mental assessment would improve detection rates."

In some parts of Canada, hospitals have made changes necessary to improve delirium detection, notes Wong. In Vancouver, British Columbia and Edmonton, for example, hospitals have created "acute care for the elderly" units based on a model of elderly care which features multidisciplinary teams of specialists; elderly-friendly surroundings, including comfortable chairs and furnishings such as clocks with large faces and numbers; and policies designed to promote independence and cognitive stimulation, such as requirements that patients use bathrooms rather than bedpans and that they have their meals at central locations rather than in bed. In an effort to be elderly-friendly, other hospitals have introduced such measures as emergency room teams dedicated to detecting delirium or hired staff such as geriatric emergency nurses.

"In pockets, this is happening, but we need a more concerted movement," says Wong.

According to Wong, there's a need to better train medical students about detecting delirium. Because it is such a common problem, it should be added to the core competencies of medical students, he says. Other health professionals who work closely with seniors, including nurses and physical therapists, should also receive training in detecting and preventing the condition.

"We also need to look at systemic changes," says Wong. "We need to have a culture that will not only support the diagnosis of delirium but also provides resources to treat it."

Treating delirium involves providing good basic care, such as ensuring patients are getting enough fluids and nutrients. It also includes reorienting them to their surroundings. Family members should ensure elderly patients have their hearing aids, dentures, glasses or whatever else they need to engage their senses. Other things that can help include daily exercise, removing medications if possible and surrounding patients with familiar objects.

"We need to change how we are caring for patients in hospitals and get back to focusing on basic health care needs," says Dr. Jayna Holroyd-Leduc, an associate professor of geriatrics at the University of Calgary in Alberta. "In these days of high technology, we can forget that these are sick patients who need good basic care. They need to be properly hydrated and have appropriate nutrition. We have to encourage them to maintain their independence and keep them oriented to where they are."

In a recent paper, Holroyd-Leduc and colleagues found that most interventions for hospital-induced delirium involve strategies to optimize sensory input, improve orientation, provide familiar objects and encourage family visits ( www.cmaj.ca/lookup/doi/10.1503/cmaj.080519). Health care providers would be wise to familiarize themselves with these and other strategies to treat and prevent delirium, because that knowledge is going to grow more valuable with each passing year, Holroyd-Leduc says. "As our population ages, we will see more and more delirium."

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Hospital-acquired delirium is a common and dangerous condition that often goes unnoticed and untreated, an oversight that experts in geriatric medicine say is costing the health care system untold millions of dollars. "Delirium is often under-recognized and underdiagnosed," says Dr. Roger Wong, president of the Canadian Geriatrics Society.

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Further support for careers and families

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Further support for careers and families

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What other agencies can support families and careers? Use the link above to find out more information and write down the answer.

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Guy's and St Thomas' NHS Foundation Trust

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Delirium (sudden confusion) usually affects people's brains for a short time. It is a common condition. Up to 1 in 3 people admitted to hospital become delirious at some time during their stay.

People with delirium might be confused or agitated and act differently than usual. They can seem alert or drowsy (sleepy). They might also have memory problems or see and hear things that are not there.

Depending on how bad the delirium is, a person may need to go into hospital for treatment and management. For others, delirium can be treated at home.

Delirium can be a frightening condition for those who have it, together with their family and carers. Not everyone remembers delirium, but those that do may find the memories distressing.

It is not always possible to prevent delirium. However, if you're at risk of delirium, there are some things that you can do to reduce the risk yourself. These things can also help you to recover from delirium when you're in hospital.

Family members and carers have an important role. They can help to manage delirium in hospital or at home.

Causes of delirium

Delirium can have different causes. We may need to do medical tests to help decide what treatment is needed.

As you get older, you are more likely to have delirium. People who are over 80 years old and have been diagnosed with some type of dementia are particularly at risk. However, delirium can happen in younger people as well, especially if they are critically ill or after surgery.

Symptoms of delirium

There are various symptoms that can help a family member or carer to recognise delirium. If you notice any of these symptoms, please tell a doctor or nurse.

Family members and carers are often the first to notice small changes. We've included quotes from family members describing behaviour and symptoms of delirium. This might help you to recognise symptoms.

Disorientation

Some people may not know where they are or what time of day it is.

"My wife has mild dementia, but we usually manage fine at home. She still recognises most of our neighbours and friends. When she was in hospital, though, she did not even recognise me or our daughter."

Unusual thoughts

Some people may become paranoid (suspicious) and mistrustful of the people around them. These thoughts can sometimes become distressing.

"After her hip operation, my mother became very confused and aggressive. She kept pulling out her drip and shouting at the nurses. It was a shock as she is usually so polite."

Poor concentration

Some people may find it difficult to follow what others say to them.

Memory loss

Some people may have memory loss. Problems with short-term memory are particularly common. People with delirium may not remember what has happened or where they are.

Sleepiness

Some people become drowsy or sleepy.

"We can often tell that my father is getting a urinary infection because he starts to get slower and becomes quiet and withdrawn. He also sleeps much more."

Agitation or restlessness

Some people may shout or become aggressive. They may get out of bed unexpectedly, which increases the risk of falling.

"My father became very confused. He was sleepy at times, and agitated and restless at other times. The community nurses gave him medicine to help control his symptoms."

Hallucinations

Some people may see and hear things that are not there.

Sudden changes

Delirium can change within the space of a day. People may be delirious, then appear normal and then be delirious again. Symptoms are often worse at night.

"The nurses told me that my grandmother had been up all night, wandering around the ward and trying to leave. However, when I visit her on the ward in the daytime, she is nice and quiet and seems OK."

Physical changes

Some people may have changes in their appetite, movement (mobility) or swallowing.

Falls

Some people may become unsteady and more likely to fall.

When you think someone is delirious

In hospital, you can tell the nurse or doctor looking after the person about the symptoms you have noticed. At home, you can talk to a GP.

The person may not know that anything is wrong. Family and friends are often the first to notice small changes.

Treatment for delirium

Some people with delirium need to come into hospital to manage the condition or what is causing it. They might also be in hospital for another reason and get delirium during their stay.

The doctors and nurses test for and manage any causes of delirium that can be treated. Examples are:

infections

abnormal blood results

constipation (finding it hard to poo)

not being able to pee

dehydration

the side effects of different medicines

Sometimes, we give the person with delirium calming or sedating medicines. We use these medicines if the person is still distressed or unsafe after we have tried other ways to keep them calm.

How long delirium lasts

Delirium usually gets better. In 6 out of 10 people (60%), the symptoms disappear within 6 days. Others may have some symptoms for longer. About 1 in 20 people (5%) may still have delirium more than a month after they first had symptoms.

Delirium is always a serious condition. Although many people make a full recovery, some people never get back to how they were completely. This may apply if you:

have dementia

have had delirium before

live in a care home (because it is likely that you already have health problems)

Leaving hospital after delirium

When a person leaves hospital after delirium, they may need more support than usual. They may be at higher risk of falls and need some changes in the home to make sure that their environment is safe.

If you think that extra support may be needed, speak to the doctors and nurses on the ward before your loved one goes home. There are many ways that we can support people who leave hospital after delirium.

We try to make sure that people get the right level of support when they leave hospital. This includes rehabilitation to improve, restore and maintain their everyday skills and mobility.

If you are concerned about anything after going home, please speak to staff at your outpatient appointment or your GP.

Useful sources of information

Alzheimer's Society gives advice and support on all types of dementia.

Phone: 0333 150 3456 or visit www.alzheimers.org.uk

Carers UK gives information and support for carers.

Phone: 0808 808 7777 or visit www.carersuk.org

Age UK gives advice, information and support for older people.

Phone: 0800 678 1602 or visit www.ageuk.org.uk

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Delirium can be treated at hospital or managed at home. This condition can be frightening for the person and their loved ones. It's important to know the signs and understand what can help.

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A group of stroke survivors with aphasia embark on a journey to find their voice and rebuild their lives.

1. What is aphasia?

2. What is the impact that aphasia has in peoples lives?

3. How could we support people with aphasia?

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Stroke can also affect children. Use the link attached to the picture to read more about this.

The FAST test can be used to identify strokes in children:

Face: Can the young person smile? Has their face fallen on one side?

Arms: Can they raise both arms and keep them there?

Speech: Can they speak clearly and understand what you say? Is their speech slurred?

Time: If you see any one of these three signs, it's time to call 999.

However, children and young people may also have other symptoms. Which symptoms could they be?

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About childhood and perinatal stroke

The term 'childhood stroke' covers stroke occurring from 29 days old up to the age of 18.

The term 'perinatal stroke' covers stroke from week 20 of pregnancy until 28 days after birth.

Several hundred children a year have stroke in the UK.

Causes and effects of stroke in babies and children

The causes and the effects of a stroke are likely to be different depending on how old the child is.

The causes of stroke in children are very different from those in adults. These webpages explain the causes, treatment and impact of stroke on children and families, and list sources of help and support.

It's important to know that for some children there may not be a clear cause of stroke, or it may take a long time to be determined.

On these pages, you can find information about the different types of childhood stroke and their causes. You can also find out about common symptoms of stroke in children and babies.

Accessible resources

The information on this page can be accessed in the following formats:

Find out more

For more information, please visit these pages:
Diagnosing and treating childhood stroke
How will my child recover?
Returning to school after stroke
Useful tips for you and your family

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About childhood and perinatal stroke The term 'childhood stroke' covers stroke occurring from 29 days old up to the age of 18.

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There are three different types of stroke:

Ischaemic stroke

Haemorrhagic stroke

Transient ischaemic attack or TIA.

What treatment will be used for each stroke type?

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Antiplatelets

If you have had an ischaemic stroke (due to a clot) you will usually be given an antiplatelet drug, usually aspirin. Antiplatelets help to stop clots from forming in your blood.

Thrombolysis

Some people with ischaemic stroke are eligible for a clot-busting drug. The drug aims to disperse the clot and return the blood supply to your brain.

The medicine itself is called alteplase, or recombinant tissue plasminogen activator (rt-PA). The process of giving this medicine is known as thrombolysis.

Thrombolysis can break down and disperse a clot that is preventing blood from reaching your brain.

For most people, thrombolysis needs to be given within four and a half hours of your stroke symptoms starting. In some circumstances, your doctor may decide that it could still be of benefit within six hours. However, the more time that passes, the less effective thrombolysis will be. This is why it's important to get to the hospital as quickly as possible when your symptoms start.

After thrombolysis, 10% more patients survive and live independently. Despite its benefits, there is a risk that thrombolysis can cause bleeding in your brain. This happens to about one in 25 people within seven days of thrombolysis, and this can be fatal in about one in 40 cases. The sooner you are treated, the better the chances of improvement, and the lower the risk of harm.

Who can have thrombolysis?

Not everyone who has an ischaemic stroke is suitable for thrombolysis. At present, around 12% of people who are admitted to the hospital with a stroke are eligible to receive it. If you are not suitable, it may be because:

You had a bleed in the brain.

You do not know or cannot tell doctors when your symptoms began.

You do not reach the hospital in time.

You have a bleeding disorder.

You have recently had major surgery.

You have had another stroke or head injury within the past three months.

Your current medication is not compatible with alteplase.

Thrombectomy

Thrombectomy is a treatment that physically removes a clot from the brain. It usually involves inserting a mesh device into an artery in your groin, moving it up to the brain, and pulling the clot out. It only works with people where the blood clot is in a large artery.

Like thrombolysis, it has to be carried out within hours of a stroke starting. Only a small proportion of stroke cases are eligible for thrombectomy but it can have a big impact on those people by reducing disability.
Find out more about thrombectomy.
Haemorrhagic stroke

If you have a haemorrhagic stroke (due to bleeding in or around the brain) you might be given treatments for high blood pressure. If you're on anticoagulants you'll be given medication to reverse the effects and reduce bleeding.

If a bleed is due to a burst aneurysm (weakened blood vessel), you might have a surgical procedure to repair the blood vessel. Surgery is also used to reduce pressure caused by a build-up of fluid.

To avoid further damage to the brain due to lack of blood supply, you may be given a drug called nimodipine.

You'll be given pain relief to help with the headaches that a bleed can cause.

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Learn more about thrombectomy. What can we do to support our patients?

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Alfred was admitted into hospital due to low potassium levels. He has history of heart problems and diabetes mellitus.
His family came to visit and have been together all afternoon. The daughter of Alfred comes to you and says Alfred is not looking well. His speech is slow and unclear.

What assessments would you do?

What actions would you take?