Stroke Service

What is stroke?

A stroke happens when blood cannot supply oxygen to the brain, leading to brain cells dying.

Stroke can happen in a couple of ways:

1. A blood clot forms, blocking the flow of blood to the brain – this is known as an ‘ischaemic stroke’.
2. A blood vessel leaks or breaks which is known as a ‘haemorrhagic stroke’.

Sometimes, blood supply is only temporarily blocked and a person will experience what doctor’s call a ‘transient ischaemic attack’ (TIA).

Signs of stroke

The Stroke Foundation recommends the F.A.S.T. test as an easy way to remember the most common signs of stroke. Using the F.A.S.T. test involves asking these simple questions:

• Face – Check their face. Has their mouth drooped?
• Arms – Can they lift both arms?
• Speech – Is their speech slurred? Do they understand you?
• Time – Time is critical. If you see any of these signs, call 000 straight away.

Treating stroke

Think you’re having a stroke? Call 000

If you or someone else experiences the signs of stroke, no matter how long they last, call triple zero (000) immediately. Stroke is always a medical emergency.

You can view a video of the Stoke Unit here.

The Stroke Unit is led 24-hours a day by highly experienced on-call stroke consultants. Your care on the Unit will be coordinated by a multi-disciplinary team including doctors, nurses and allied health professionals such as physiotherapists, occupational therapists, speech pathologists, dietitians and social workers.

The stroke team also visit inpatients on other wards at JHC who show any signs of neurological deterioration and / or potential stroke.

The team meets weekly to discuss each patient’s medical status, rehabilitation progress, goals of care and discharge plans - all of which are aligned with the Stroke Foundation’s best practice guidelines.

In the first 24 to 48 hours following a stroke, patients will be treated in the hyper-acute section of the ward where nursing staff carry out regular, highly comprehensive ‘observations’ to monitor their wellbeing.

The staff also follow a ‘72-hour stroke protocol’ which includes four hourly observations of vital signs and neurological functioning, frequent blood sugar monitoring and post-void bladder scans.

In addition, patients will also have a full allied health assessment within 48 hours of admission to the Stroke Unit – early assessment and intervention is imperative for optimal recovery.

The Unit contains a conveniently co-located Therapy Zone, which provides space and equipment for specialised physiotherapists, occupational therapists and speech pathologists to work.

The hospital is informed of a person with a potential stroke coming into the Emergency Department (ED) by St. John Ambulance. This allows the stroke team to prepare and meet the person as soon as they arrive.

The ED has in place a stroke pathway which is activated when a patient has either walked in or come via ambulance.

This alerts all necessary staff members including the hospital’s radiology provider Perth Radiology Clinic (PRC).

Patients who are suitable candidates for endovascular clot retrieval will be transferred to Sir Charles Gairdner Hospital, home to the State’s Neurological Intervention and Imaging Service of WA (NIISwa) – one of only two such services in the nation. Only a small percentage of all ischemic strokes will be medically appropriate for this.

Clot retrieval is a complex but minimally invasive technique that involves insertion of a clot-retrieving device into the femoral artery through the groin to the brain where the device can then extract the clot aided by modern imaging technology.

Joondalup Health Campus may also transfer certain patients who suffer a haemorrhagic stroke (a brain bleed), depending on the type of bleed and the patient’s history. Other patients will be admitted to the hospital’s Stroke Unit, under the expert care of the hospital’s stroke team.

Our visiting hours are 10am – 8pm.

The Stroke Unit has a rest period for patients from 1pm-3pm. During these hours we ask that visitors stay away to allow patients the rest they need to help with their recovery.

Prior to going home a comprehensive plan will developed by the stroke team to ensure both you and your family or carers understand and can plan for your transition back into the community.

This plan will be tailored to each individual and may include:

• Information from hospital’s allied health team. Some patients may be referred to the Government-funded Rehabilitation in the Home (RITH) team, who will help to set goals and continue to work on rehabilitation as appropriate. For continuity of care, information from JHC’s allied health team will be automatically forwarded to RITH.
• Details of a post discharge Occupational Therapy home visit, if recommended by the team.
• A discharge summary which will include the full history of a patient’s presentation, diagnosis and treatment at Joondalup Health Campus – a copy will also be sent to the patient’s GP and to RITH, where appropriate.
• Medication information from pharmacy – including instructions on what medications to take, when and how to take them.
• Details of any plans our social work team have arranged – this may include help with cooking, cleaning, personal care and continence products.
• Details of a post discharge occupational therapy home visit, if recommended by the team.

Following discharge, patients may be referred to the hospital’s stroke outpatient clinics for any ongoing care and rehabilitation.

Occupational therapy, physiotherapy and speech pathology all run specialist stroke outpatient services. A medical outpatient clinic also runs to provide medical follow-up care and support.

Patients will receive a call to arrange any ongoing outpatient appointments.

If you suspect you or someone you know is having a stroke dial 000 immediately.

In WA statewide protocols exist with St. John’s Ambulance paramedics. These protocols help to assess possible acute stroke patients in the community. Where appropriate, they will take them directly to Sir Charles Gairdner Hospital for initial assessment and treatment.

We also may accept referrals from other hospitals in cases where Joondalup Health Campus is closer to home and staff agree it is appropriate for their rehabilitation needs.

The Stroke Unit gives patients who reside in Perth’s northern suburbs access to treatment and rehabilitation. Our stroke consultants include:

• Dr Kevin O’Connor
• Dr Shivlal David
• Dr Julian Rodrigues
• Dr Janavi Dunuwille

These consultants are well supported by a team of junior doctors, including registrars and resident medical officers.

Specialised nursing staff run the unit and understand the unique needs of people who have experienced stroke.

The allied health team comprises staff who have specialised in stroke and are experienced working with people who are rehabilitating, including physiotherapists, occupational therapists, speech pathologists, dietitians and social workers.

We are located on Level 3 of the main public hospital.

Call our switchboard on (08) 9400 9400 and ask to be put through to the Stroke Unit.