As part of a collaborative initiative from both Emergency Medicine Department (EMD) and Neurology High Dependency (HD) to shorten the Door-to-Needle (DTN) time for the hyper-acute treatment of stroke patients, the Hyper Acute STroke ENdo-vascular (HASTEN) Team was formed. By reducing DTN time and increasing the percentage of patients given treatment within 60 minutes (international standard), stroke patients have higher likelihood of achieving better outcomes.
Upon receiving standby message from the Singapore Civil Defence Force (SCDF), Neurologists and Neurology-trained nurses will be activated. EMD doctors and nurses will first expedite a brain scan and other essential investigations. Neurology Nurses will perform rapid neurological assessments to determine stroke-related deficits, exclude stroke mimics and optimize patient for time- sensitive treatment. Intravenous recombinant tissue plasminogen activator (rtPA) will be administered in the EMD after the HASTEN team reviews. The collaborative efforts from all plays a vital role in ensuring efficient and effective management for our patients in this fast- paced setting.
As stroke management evolves to include endovascular therapy, Department of Diagnostic Imaging (DDI), Neurointerventionists, and Anesthetists have also combined efforts to expedite time to treatment. The HASTEN service continuously improves as patients' needs changes.
