TF4UKR Visit Report – Dr Yuliia Kit

Within the ESO Department-to-Department Visit Programme I had a great chance to visit Karolinska University Hospital in Stockholm at a kind invitation of Dr. Michael Mazya, the head of stroke service. During this time, I had the opportunity to be present during the stroke patients’ treatment, performing neuroimaging, thrombectomy and discussing clinical cases.

The head of the stroke service, Dr. Michael Mazya acquainted me with the hospital and department. All the staff in the department was very kind and glad to share their experience, told about their work routine and answered my questions.

During the time I spent with Dr. Michael Mazya, I had the possibility to be present at all stages of providing healthcare for stroke patient: from the admission to neuroimaging and choosing a treatment method.

I was impressed how clearly and coherently the stroke care system in Sweden works. The patient is delivered to the nearest hospital that provides stroke healthcare. Mechanical thrombectomy is performed at the Karolinska Hospital, so if the ambulance suspects large vessel occlusion at the pre-hospital stage the patient is referred directly here. Also, patients can be transferred here from other hospitals.

In the hospital there is separate optimized stroke patient route with minimum time consumption. After the ambulance call, the neurologist on duty informs all the staff about the expected patient through the emergency department. The entire team that provides care for a stroke patient is mobilized – neurologists, neuroradiologists, interventionists, nurses.

Thrombolysis begins immediately after the exclusion of hemorrhage on the native CT scan in the CT room, and continues either in the department or in the angio-operating room, if there are indications for thrombectomy.

The average “door-to-needle” time is 12 minutes, during the period of my visit the fastest was 7 minutes. Excellent teamwork saves precious minutes for a stroke patient.

A lot of doctors (senior and junior), nurses, physical therapists and other specialists work here to ensure high quality care for patients. Nurses’ work is extremely important, because their assistance is a key point in providing care.

Also, air medical service works great here. I had the opportunity to observe one of the patients was admitted by helicopter in the morning with wake-up stroke. Each helicopter is equipped as an ambulance car.

Medical information system is very convenient in Sweden. It is a united register of patient data that includes data from family doctor and all highly specialized care. Due to this doctor can easily review the entire patient’s history.

After discharge from the hospital, all patients are recommended to be re-examined after 90 days by a stroke physician to monitor the patient’s condition and correct the treatment if necessary. In Ukraine, we have also started this practice and believe this will improve patient compliance and secondary prevention of stroke.

And, of course, I had the opportunity to walk and feel the atmosphere of Scandinavia in the incredible city of Stockholm, which attracts with amazing architecture, ancient streets, history and a comfortable sea climate.

I am sincerely grateful to the Dr. Michael Mazya and all the staff of stroke unit of Karolinska University Hospital for their hospitality, for all interesting and fulfilling days I spent here.

I’d like to thank ESO and Task Force 4 Ukraine initiative for the opportunity to visit one of the leading stroke departments in Europe. This is a very valuable experience that will definitely help to improve the level of stroke care in Ukraine.

Sincerely, Yuliia Kit.