CVA

Background
 Massive MCA infarct
 Post stroke day 8
 Family wish to talk to you

Interview
 Check understanding
 Explain stroke due to occlusion of a blood vessel in the brain causing death of the
brain tissue in a large part
 Confirmed with CT brain which shows what’s happening in the brain

Family asks into chance of recovery.

 Initial improvement due to reduce of brain swelling, may occur in 2 weeks
 Brain cells may take up function of the other part which is damaged but it may
take years and is unpredictable
 Therefore overall is unpredictable
 Ensure baseline neurological status well documented
 May review in 2 weeks for progress

Family asks into changing into private

 Explore reason why, any problems in public
 Ensure patient is under best care
 Under dedicated unit (stroke unit)
 Multidisciplinary care
 Physio, occupational, speech
 Helps in exercising
 But recovery takes time and unpredictable
 If family would like second opinion – will arrange consultant to see them

Family asks into reason for changing around

 Acknowledge concern and things were not going too well so far
 Explain need for dedicated unit for better outcome
 Will not change ward in near future

 Identify social support

503670118.doc (CVA) Page 1 30 December 2009

Heyson Chan