The Countdown Begins: Why Time Matters in a Stroke
When a stroke hits, every second counts. Blood flow to the brain is disrupted, and brain cells begin to die. In Ireland, about one in four people will experience a stroke in their lifetime, with roughly 7,500 cases annually and nearly 90,000 people living with its after-effects. Yet mortality from stroke has fallen—from 19% in 2008 to 11% recently—thanks to a streamlined, time‑sensitive care pathway and 22 dedicated stroke units across the country.
Recognition and Immediate Action: The FAST Message
Early recognition is crucial. Signs include facial droop, arm weakness, speech difficulty, and time to call emergency services. Public awareness campaigns have popularised FAST (Face, Arm, Speech, Time). If stroke is suspected, calling an ambulance is essential, not delaying for family advice or a GP visit. “Time-dependent” treatments mean the fastest possible dispatch and hospital arrival dramatically improves outcomes.
From Ambulance to ED: A Coordinated Arrival
In the Dublin area, the National Ambulance Service and Dublin Fire Brigade prioritise suspected strokes. Ambulance crews assess en route and alert a stroke unit so staff can greet the patient at the ED door. The aim? A rapid “pit stop” where the patient’s status is stabilised, lines logged, and initial labs drawn—before proceeding to advanced imaging.
Rapid Imaging: The Crucial Scanner Step
CT imaging is the cornerstone of the stroke diagnosis, revealing whether a bleed or a blockage is present. If the patient’s time of onset is uncertain, a CT perfusion scan helps identify salvageable brain tissue. Radiographers and radiologists work under intense time pressure, with AI-assisted tools flagging concerns and guiding decisions in seconds.
Ischemic vs Haemorrhagic Stroke: Tailored Treatments
Two main stroke types require different responses. An ischemic stroke, caused by a clot, may be treated with clot-busting drugs (thrombolysis) within four and a half hours. If a large vessel blockage is confirmed, a thrombectomy can physically remove the clot—often a decisive intervention. Haemorrhagic strokes, where bleeding is the issue, are treated differently to control bleeding and prevent further damage.
The Stroke Unit: Specialised Care Improves Outcomes
After imaging, patients move to the acute stroke unit—an eight-bed ward within Tallaght University Hospital’s William Stokes Unit. Specialist nurses, physiotherapists, and dietitians form a multidisciplinary team focused on minimising disability and speeding recovery. Studies show stroke patients cared for in dedicated units have higher survival rates and better functional outcomes than those on general wards.
Rehabilitation and Early Discharge: Getting People Home
Recovery continues beyond the CT scanner. Rehabilitation starts early, with tailored physiotherapy and support to restore function. For some, Early Supported Discharge (ESD) brings people home with regular home-based therapy, four visits a week, and ongoing nursing and social work support. This approach preserves independence, reduces hospital stays, and helps avoid long-term residential care.
Long-Term Care: Six-Mound Follow-Up and Prevention
Six‑month review clinics bring survivors back to review their progress with clinicians, physiotherapists, and speech therapists. Prevention remains a priority: blood pressure control, healthy eating, regular activity, and avoiding tobacco and excessive alcohol. As Ireland’s population ages, stroke prevention and speedier treatment remain central to reducing the overall burden of disease.
Voices from the Ward: Real-Life Impact
Stroke survivors and their families illustrate the journey from acute care to recovery. Dietitians address nutrition needs after swallowing difficulties, while rehabilitation specialists help patients regain mobility. The path from emergency to home can vary, but the common thread is rapid, coordinated care and a patient-focused approach that emphasises independence and quality of life.
Looking Ahead: A System Ready to Meet Growing Needs
Ireland’s stroke program has evolved dramatically since 2008, with more dedicated units and evidence-based treatments now standard practice. While the demand may rise, the emphasis on speed, accuracy, and comprehensive rehabilitation makes stroke care a public health success story. Continued investment in prevention and post-stroke support will help keep more people living independently after a stroke.
