Hyperacute and Acute Stroke Therapy Teams
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The Stroke therapy department at St George’s Hospital is based within the Atkinson Morley Regional Neurosciences Centre. The Hyperacute Stroke (HASU) therapy team specialises in the assessment and treatment of stroke patients from across South West London. The Acute Stroke therapy team specialises in the treatment of local St George’s Stroke patients. If you are assessed on the Hyperacute Stroke Unit and do not live locally to St George’s you will be transferred to an Acute Stroke Unit (ASU) closer to your home to continue your rehabilitation. This transfer to the ASU typically happens within 72 hours of admission.
Main telephone number: 020 8725 3009
Additional telephone number: 020 8725 3662
HASU telephone number: 020 8725 1326
Thomas Young Ward telephone number: 020 8266 6544
08:30 – 16:45 Monday to Friday
15:00 - 20:00 HASU visiting hours
15:00 - 2000 Thomas Young Ward visiting hours
What is a stroke?
A Stroke is sudden and happens when the blood supply to the brain is reduced and brain cells become damaged or destroyed. Stroke can affect people in many different ways. Your assessment and treatment will depend on the nature of these symptoms. It is common to experience physical symptoms (weakness, changes in sensation, difficulty with co-ordination, increased muscle activity), cognitive symptoms reduced memory, poor concentration/attention, poor problem solving, reduced insight into difficulties experienced, difficulties multi-tasking), and speech and swallow symptoms (difficulty swallowing food and/or drinks, word finding difficulties, difficulty understanding what people say, slurred speech, changes in social communication skills).
What happens if I have a Stroke?
The London Ambulance service will bring you to St George’s Hospital HASU where a multi-professional team of stroke skilled staff will be involved in your care.
All people admitted to the Hyperacute Stroke Unit will be assessed by the Occupational Therapist and Physiotherapist for cognitive and physical symptoms. If you have any problems with your communication or swallow you will be referred to the Speech and Language Therapist for assessment. After your assessment process on HASU you may be able to return home or may require further rehabilitation.
What if I need more rehabilitation?
This decision will be made with you, your family and the stroke multidisciplinary team. If you need to remain in hospital and live locally you will be moved to the St George’s ASU.
What does rehabilitation involve?
Stroke rehabilitation is the process of working to restore functional ability and quality of life to those people who experience new disabilities as a result of their stroke.
This rehabilitation process usually begins as soon as a person is well enough to work with nurses and therapists. Following your assessment period an individually tailored programme of rehabilitation is started. Therapy goals are often set as part of this process, representing graded steps to help you maximise your recovery.
Your rehabilitation will usually be overseen by a named therapist.. The roles of the main therapy disciplines are described below:
Occupational Therapy (OT)
Occupational Therapy aims to support you to remain as independent as possible in areas of day to day living. Whether that is managing self care activities such as dressing, or helping you return to leisure/work life.
We will find out more about your lifestyle and assess what you are finding difficult after your Stroke. As part of this process we will observe how you carry out day to day tasks.
We will aim to see you up to 5 sessions a week for up to 45 minutes to work on goals that are important to you. When you are ready to leave hospital the Occupational Therapist may suggest completing a visit to your home to ensure it is safe for you to return, supply any necessary equipment and provide advice to family and carers.
PT will address the more physical symptoms of your stroke that are impacting on your ability to move yourself around (i.e. in bed or getting from A to B) or carry out tasks. It might involve working on compensatory strategies to help you gain more independence.
Physiotherapy will take place either on the ward or in the gym and you will receive up to five sessions of physiotherapy a week, each session lasting up to 45 minutes. Your physiotherapist may provide you with additional exercises that can be done at your bedside, either on your own or with a friend/relative to support you. It might be suitable for you to attend the supervised balance group that runs twice a week in the gym.
Speech and Language Therapy (SLT)
The SLT team work with the many people who have problems communicating and/or swallowing following a stroke.
The SLT team will assess, and provide help with the early stages of managing, difficulties with swallow and communication you may have after stroke.
We also support families, friends, hospital staff and carers to understand any changes to communication and swallowing that have occurred, and can provide information, advice and strategies so that they can support your recovery process.
What happens after the Acute Stroke Unit?
After a period of rehabilitation on the stroke unit you/your relative will be discharged from the hospital. The location you/your relative are discharged to will depend on your progress after your stroke.
You/your relative may require further rehabilitation in your/their home from community therapy teams or you may require a further in-patient rehabilitation stay at another hospital site.
If you are not able to return home and further rehabilitation is not required the therapy team (as part of the wider MDT) will support you/your family in the discharge decision making process. This will aim to ensure your/your relatives on-going care needs have been considered in order to establish your/your relatives discharge destination.
The department consists of, Specialist Occupational Therapists, Physiotherapists and Speech and Language Therapists, Rotational Therapists and Therapy Technicians.
The multi disciplinary team will endeavour to organise a family meeting for all Stroke patients. The time frame for this may vary slightly depending on the patient’s needs. This is an opportunity to discuss the patient’s progress and on-going plans such as where the patient may go to next.
The Sentinel Stroke National Audit Programme (SSNAP) is a programme of work which aims to improve the quality of stroke care by auditing stroke services against evidence based standards nationally. All Stroke patients admitted to the St George’s Stroke Service will have data relating to key performance targets entered into the SSNAP data set by the SSNAP co-ordinator.