Vera had a thrombectomy, unblocking her right middle cerebral artery (MCA). She is transferred to the hyperacute stroke unit after waking up from the general anaesthetic in recovery. The nurses monitor her condition carefully (see Iain’s story).
Vera is much better (mild facial weakness and mild drift of arm and leg, normal visual fields and slight inattention of left) the following day. Her NIHSS has improved from 15 before transfer to 4.
The stroke physicians assess her progress twice daily to determine when she might be fit for repatriation.
Indicate which of the following 7 statements about repatriation are True or False
- Repatriation should only occur if the patient is medically stable enough – True – the patients condition should be reassessed just prior to repatriation to confirm they are still stable.
- Repatriation should occur within 4 hours of completion of the thrombectomy – False – if the patient does not undergo thrombectomy then it may be appropriate to immediately repatriate the patient if they are stable, but after thrombectomy the patients may develop serious complications which cannot be managed in an ambulance (see Iain’s story).
- Repatriation requires an emergency ambulance with paramedics and nurse escort – False – if the patient is stable an emergency ambulance with paramedics and a nurse escort is not needed.
- The spoke hospital should accept the patient for repatriation as soon as the patient is stable enough to transfer – True – if repatriation is delayed another patient may not be able to receive thrombectomy because the thrombectomy centre does not have sufficient beds to safely accept the patient.
- Repatriation may be delayed if the patient develops complications – True – patients who develop complications including brain swelling (malignant MCA syndrome) may need to be cared for in the hub.
- Patients should not be discharged home from the thrombectomy hub – False – if the patient has made a good recovery, and is assessed to be fit for discharge home this is OK.
- Delays in repatriation will be monitored by the Scottish Stroke Care Audit – True – the SSCA will record several data items which will indicate the performance of Thrombectomy service at Hubs and Spokes. including relays to repatriation.
