Interventions for Ischaemic Stroke

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Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community sensitization on early identification of signs and symptoms of stroke using FAST (facial weakness, arm weakness, speech problems, and time to call)	Lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise. Monitor blood pressure and sugar through community screening services	Symptom recognition using FAST (Face Arm Speech Test)	ABC (Airway, breathing, and circulatory) support Immediate transfer of suspected cases to a higher-level health care facility	Home-based self-management rehabilitation Physical activity counselling and exercise training Provision and training in the use of assistive products	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Primary Care
Patient education on early identification of signs and symptoms of stroke using FAST (facial weakness, arm weakness, speech problems, and time to call)	Guidance on lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise. Screening and treatment of CVD risk factors	Symptom recognition using FAST (Face Arm Speech Test)	ABC (Airway, breathing, and circulatory) support Immediate transfer of suspected cases to a higher-level health care facility	Early physical, mental and speech rehabilitation Provision and training in the use of assistive products	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Community engagement [community sensitization on risk factors for ischaemic heart disease and preventive measures such as regular exercise, healthy diet, and stress management] Provision of IEC/BCC materials	Screening and treatment of CVD risk factors	History Physical examination Neurological examination Troponin test Complete blood count Basic metabolic panel Coagulation factors, including PTT, PT, and INR Electrocardiogram (ECG)	ABC (Airway, breathing, and circulatory) support Thrombolytic medications Antihypertensive medication Glycaemia control Temperature control DVT Prophylaxis Anti-seizure medications Antiplatelet treatment (e.g. ASA) Lipid lowering medications	Early physical, mental and speech rehabilitation	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Information to patients/families/communities on Ischemic heart disease including prevention measures Provision of IEC materials Advocacy for patients with ischemic heart disease including for availability of services Health workers training on Ischemic heart disease	Screening and treatment of CVD risk factors	History Physical examination Neurological examination Troponin test Complete blood count Basic metabolic panel Coagulation factors, including PTT, PT, and INR electrocardiogram (ECG) Computed tomography (CT) Magnetic resonance imaging	Thrombolytic medications Antihypertensive medication Glycaemia control Temperature control DVT Prophylaxis Anti-seizure medications Antiplatelet treatment (e.g. ASA) Lipid lowering medications Mechanical thrombectomy	Early physical, mental and speech rehabilitation	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community sensitization on early identification of signs and symptoms of stroke using FAST	Lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise. Monitor blood pressure and sugar through community screening services	Symptom recognition using FAST (Face Arm Speech Test)	ABC (Airway, breathing, and circulatory) support Immediate transfer of suspected cases to a higher-level health care facility	Home-based self-management rehabilitation Physical activity counselling and exercise training Provision and training in the use of assistive products	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Primary Care
Patient education on early identification of signs and symptoms of stroke using FAST	Guidance on lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise. Screening and treatment of CVD risk factors	Symptom recognition using FAST (Face Arm Speech Test)	ABC (Airway, breathing, and circulatory) support Immediate transfer of suspected cases to a higher-level health care facility	Cardiac rehabilitation: nutritional counselling, weight management, blood pressure management, lipid management, diabetic management, smoking cessation, psychological management, physical activity counselling, exercise training Provision and training in the use of assistive products Occupational therapy Speech and language therapy	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Referral Facility: General
	Screening and treatment of CVD risk factors	History Physical examination Neurological examination Troponin test Complete blood count Basic metabolic panel Coagulation factors, including PTT, PT, and INR Electrocardiogram (ECG)	ABC (Airway, breathing, and circulatory) support Thrombolytic medications Antihypertensive medication Glycaemia control Temperature control DVT Prophylaxis Anti-seizure medications Antiplatelet treatment (e.g. ASA) Lipid lowering medications	Cardiac rehabilitation: nutritional counselling, weight management, blood pressure management, lipid management, diabetic management, smoking cessation, psychological management, physical activity counselling, exercise training Provision and training in the use of assistive products Occupational therapy Speech and language therapy	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
	Screening and treatment of CVD risk factors	History Physical examination Neurological examination Troponin test Complete blood count Basic metabolic panel Coagulation factors, including PTT, PT, and INR electrocardiogram (ECG) Computed tomography (CT) Magnetic resonance imaging	Thrombolytic medications Antihypertensive medication Glycaemia control Temperature control DVT Prophylaxis Anti-seizure medications Antiplatelet treatment (e.g. ASA) Lipid lowering medications Mechanical thrombectomy	Cardiac rehabilitation: nutritional counselling, weight management, blood pressure management, lipid management, diabetic management, smoking cessation, psychological management, physical activity counselling, exercise training Provision and training in the use of assistive products Occupational therapy Speech and language therapy	Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families