Re:At 88, doctor pursues a long-ignored treatment for stroke...
by thisrod on Sunday April 08, 2018 @11:03PM
(#16790002)
Remember that Australia is ridiculously urbanised. About 80% of Western Australians live in Perth. Contrasted to the US, the most remote Australians must be a lot further from a referral hospital, but the median Australian might actually be closer.
I worked with stroke centers, doctors, etc in building stroke access systems, and that doesn't fly with reality.
Number 1, is that its hard for patients to recognize they are having a stroke. so "If called promptly" is a bit of unrealistic idealism.
Although they say 4 hours, tPA administered after 1 hour has lost most of its benefit, and places that can do thrombectomy 24/7 (in US dedicated stroke centers) is not numerous. You are losing a lot of that hour just for time for the helicopter to warm up, find a spot, and land + your ambulance time getting to /stabilizing the patient.
I'm sure the patients on your beat had suitable access, but that's a bit of selectivity bias no? In the US, although the majority of the population is within the golden hour, there are still a ton of population that does not have access to a stroke center. I find it extremely hard to believe that this is not the case in Australia - where I have heard stories of people getting a finger cut off and having to drive 3 hours to the nearest hospital.