Trombolisis en Servicio de Urgencia Hospital de Talagante
La situación de pacientes con Accidente Cerebrovascular isquémico en Hospital de Talagante -hasta el inicio de la teletrombolisis- contemplaba la estabilización del usuario, la realización de TAC para confirmar la patología y las medidas de neuroprotección con posterior evaluación por el neurólogo.
Desde el punto de vista terapéutico del evento no había posibilidad de manejo; incluso nuestro centro de derivación no contaba con esta posibilidad disponible.
Existía desde hace muchos años la posibilidad de tratamiento con activador tisular del plasminógeno pero no estaba disponible en la mayoría de los centros. Lo anterior se originó principalmente por dos razones: no había imagen disponible o no existía especialista que realizará la evaluación del paciente y la indicación de trombolisis.
Dado lo anterior, el paciente evolucionaba con su cuadro hacia la invalidez o la muerte en algunos casos.
La incorporación de nuestro Hospital al proyecto de TELE ACV, gracias a que el recinto hospitalario cuenta con TAC, cambió radicalmente la situación del paciente, ya que hoy cuentan con la oportunidad cuando corresponde de ser sometido a la trombólisis y así contar con la evaluación por parte de un especialista de la imagen y la evaluación en conjunto con el médico local y neurólogo en tiempo real. Lo anterior permite obtener a los pacientes el tratamiento que necesita y en los tiempos precisos para que sea efectivo.
El equipo local ha sido testigo en cómo cambia con esta posibilidad la vida del paciente, cuyo destino era anteriormente la invalidez. Mientras tanto, gracias a estos avances, hoy es tratado y muchas veces mejorado.
La integración efectiva de la red pública es otro factor positivo en este análisis. Hoy ante la imposibilidad de realizar la prestación en nuestro hospital, rápidamente se obtiene la derivación para tratamiento del paciente, ya sea a nuestro centro de derivación o al hospital que otorgue la prestación, aunque no sea del mismo Servicio de Salud. Incluso para prestaciones más complejas como Trombectomía tenemos opción de trabajar en Red con resultados nunca pensados para un Hospital de Mediana Complejidad.
Crecimiento de todo el equipo de salud en la evaluación y manejo de este tipo de pacientes con apoyo incondicional de médicos del equipo Tele ACV.
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