COVID-19’s Shadow: Stroke Care in Ireland
The COVID-19 pandemic drastically changed healthcare, especially for time-sensitive conditions like strokes. This study investigates the pandemic’s impact on stroke care in Ireland, offering insights from survivors, caregivers, and healthcare professionals on the challenges and adaptations during this difficult period.
Triage Challenges Unveiled
Improving public knowledge about stroke is a crucial factor in triggering the stroke chain of survival, according to the study. Education empowers individuals to identify and react to stroke symptoms quickly. However, the practical application of this awareness sometimes fell short.
Although ambulances responded promptly, the COVID-19 crisis affected response times, according to the research. Healthcare professionals also observed that the categorization system within the ambulance service might have inadvertently ranked stroke calls lower than others, potentially delaying care. This could have significant impacts on patient outcomes.
Hospital Pathway Difficulties
Healthcare professionals observed changes in how stroke/TIA patients presented during the pandemic. These modifications included fewer presentations, delays in arrival, and, in some instances, more severe stroke cases. Fear of contracting the virus influenced some people to delay seeking care.
The experiences of stroke survivors in the emergency department differed widely. Some found quicker clinical reviews during the initial wave, while others faced lengthy wait times during subsequent waves. Hospital staff mentioned that the need for COVID-19 testing could delay care, although the core stroke pathway remained intact.
Time is Brain: A Critical Factor
The concept of “time is brain” underscores the urgency of stroke care, especially for ischemic strokes. Caregivers understood the implications of delayed treatment, such as potential brain damage and missed opportunities for treatments like thrombolysis. Delaying even for a short amount of time might have serious consequences.
Healthcare professionals highlighted the importance of rapid decision-making in treating hyperacute stroke cases. Despite the challenges of the pandemic, they stressed that time was crucial. Unfortunately, many survivors presented outside the thrombolysis window. The study also noted that family members’ involvement influences prompt hospital arrivals.
Communication and Connectivity Hurdles
Stroke survivors and their families frequently communicated using phone and video calls during the pandemic. Healthcare professionals facilitated communication by using technologies such as tablet devices and apps. But these methods didn’t suit everyone, particularly older adults. Communicating with individuals impaired by stroke was also challenging.
HCPs adapted quickly to facilitate communication during COVID-19, yet challenges remained due to PPE and cognitive impairments resulting from the stroke. Despite this, many healthcare professionals maintained effective communication throughout the stroke chain of survival. The pandemic’s public health messaging also played a role, with some believing it might have deterred patients from seeking needed care.
COVID-19’s Far-Reaching Impact
Stakeholders noted the prioritization of COVID-19 over other health issues, leading to a decline in stroke awareness and delayed care. All groups believed COVID-19 took precedence over all other conditions. The use of personal protective equipment (PPE) became an essential part of the stroke pathway, both pre-hospital and hospital-based.
Visitor restrictions during the pandemic were a major concern, with stakeholders highlighting their impact on patient morale and recovery. Healthcare professionals expressed that this policy was “the worst part of the whole thing.” The study revealed a decrease in staffing levels during the pandemic.
According to the World Stroke Organization, stroke continues to be a major global health concern, ranking as the second leading cause of death worldwide.
World Stroke Organization.
The study emphasized that understanding these dynamics is crucial for optimizing stroke care and guaranteeing timely treatment access. Future research is necessary to grasp the extended effects of factors like visitor restrictions and to examine the experiences of acute stroke care during later phases of COVID-19.
