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Parc Taulí is consolidated as a center of expertise in the care of patients with ischemic stroke, with the activation of a new circuit that has been launched thanks to the implementation of several structural improvements and the work of a multidisciplinary team of professionals. The new circuit is making it possible to reduce the care time for these patients, which has an impact on an improvement in survival rates and the sequelae that this serious condition entails.
Ischemic stroke is one of the most common and important health problems today. It affects 13.000 people every year in Catalonia, causing different levels of disability in 45% of those affected. It occurs when a thrombus blocks an artery, preventing blood flow and oxygen from reaching the brain region that depends on that artery. It is the first cause of severe disability and dependency in adults and is among the top three causes of mortality in Spain. At the Parc Taulí Emergency Department, an average of two cases of stroke are treated every day.
Parc Taulí has been participating since its inception in the implementation of the Stroke Code in Catalonia, an urgent action protocol that involves the activation of all healthcare devices to offer immediate and adequate care to patients with suspected stroke. The main objective is for the care of the affected person to be carried out as quickly as possible to avoid the progression of the disease and its sequelae.
In recent years, several actions have been taken such as the installation of a CAT scan in the Emergency Department in the summer of 2020, the acquisition of a biplane angiographic room with interventional software and with the new unit of 'ictus located on the first floor of the Ripoll building. From the care point of view, the Neurology Service has been strengthened and the interventional radiology on-call has been extended to 24 hours a day, 365 days a year.
From the professional side, a multidisciplinary team has recently worked on the implementation of the new Stroke Code circuit, which was launched last July 6. This new circuit has modified the alert system, made the process of admission and request for tests easier, and has modified the flow of the patient, moving them directly to the CAT from their entrance to the Emergency Department, also clarifying the criteria for entry to each of the critics' units.
In strokes, the needle time – the time between the patient's arrival and the administration of the intravenous treatment – is a critical factor in the patient's recovery. Since the entry into force of the new law, 20 patients have been treated at Parc Taulí with intravenous fibrinolysis – administration of a drug intravenously with the aim of breaking up a clot in an artery – with an average needle-holding time of 21 minutes, records that are clearly better than those required by the Catalan Health Service, which mark the target in 30 minutes on average and which, therefore, place Parc Taulí at the head of the hospitals with the best times in Catalonia.
On the other hand, the average of the puncture holder - the time elapsed from the moment the patient arrives at the Emergency Department until the femoral puncture is performed to extract the clot that obstructs an artery - has also managed to be clearly positioned for below the required 70 minutes, with an average of 56 minutes. The implementation of the new circuit has reduced times by 19 minutes compared to 2021.
These very positive results have been the result of the multidisciplinary work of the Neurology Service, the Emergency Service (medical and nursing areas), the Diagnostic Imaging Service, Interventional Radiology, the Critical Care Service, Patient Management and the essential collaboration of the Digital Organization and the litter holders.