Stroke Unit in the event of a stroke.

A stroke rarely gives warning: suddenly one corner of the mouth droops, an arm becomes weak, speech is slurred. Then it is time to call 112. On the stroke unit, patients are closely monitored during the first few days and receive early therapy.

  • Emergency number 112
  • Round-the-clock monitoring
  • Neurological rehabilitation on site

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  • 112call even if the signs fade
  • FASTface, arms, speech – then time is what counts
  • CTshows whether it is a clot or a bleed
  • 24 hof monitoring at least, often several days

Procedures according to the guideline. The ambulance service decides which hospital to go to.

Stroke

When the brain is starved of blood.

In a stroke, part of the brain suddenly stops receiving enough blood. Usually a blood clot blocks a vessel; doctors then speak of a cerebral infarction. Less often, a vessel ruptures and blood leaks into the brain. Without blood flow, the nerve cells lack oxygen; the longer this lasts, the more tissue is lost. Experts sum this up in three words: time is brain.

Typically, the signs appear suddenly: paralysis or numbness on one side of the body, a drooping corner of the mouth, difficulty speaking or understanding, visual disturbances, dizziness with an unsteady gait or a sudden, very severe headache. The FAST test helps with assessment: Face – ask the person to smile; Arms – ask them to stretch both arms out in front; Speech – ask them to repeat a simple sentence. If any of these checks is abnormal, it is Time: call 112 immediately.

Signs that disappear again after a few minutes also need immediate medical attention. Such a temporary disruption of blood flow can precede a stroke. The specialist societies’ guideline therefore recommends treating people with a stroke, and those whose signs have recently subsided, on a stroke unit – regardless of age and severity.

The stroke unit is a ward for the first few days after a stroke. Blood pressure, heart rhythm, breathing, oxygen, blood sugar and temperature are monitored continuously, so that any deterioration or a new stroke is noticed early. At the same time, the cause is investigated, and nursing care and therapy begin as soon as the patient’s condition allows. In this way, the unit combines acute treatment, diagnosis and the first step back into everyday life.

The stroke unit

What the unit provides.

Monitoring

Monitors record blood pressure, heart rhythm, breathing and oxygen without interruption. This means changes in circulation or symptoms are noticed early.

Finding the cause

Ultrasound of the blood vessels in the neck and brain, ECG monitoring over several days and a heart ultrasound show where the clot came from. Prevention is then tailored accordingly.

Early therapy

Swallowing is tested before the first meal. Nursing staff, physiotherapy, occupational therapy and speech and language therapy work on movement, speech and everyday tasks as soon as the patient’s condition allows.

The chain of care

From the first signs to rehabilitation.

Each stage has its own task. The smoother the handovers, the sooner treatment begins.

  1. Emergency call

    Anyone who notices signs of a stroke calls 112, notes the time and stays with the person affected. Eating and drinking are off limits, because swallowing may be impaired.

  2. Ambulance service

    The crew checks consciousness, circulation and blood sugar, drives to a hospital with a stroke unit and alerts the hospital in advance.

  3. Emergency department

    Neurological examination, blood tests, ECG and a CT scan of the head. This shows whether a clot or a bleed is the cause.

  4. Acute treatment

    If there is a clot, thrombolysis can reopen the vessel; if a large artery in the brain is blocked, transfer to a centre for catheter treatment may be considered. In the case of a bleed, blood pressure and monitoring take priority.

  5. Stroke unit

    Several days of monitoring, searching for the cause, a swallowing test and therapy that starts early. Measures to prevent a further stroke are initiated.

  6. Afterwards

    Further treatment on a general ward, then home or to neurological rehabilitation. Your GP continues the preventive treatment.

Insurance

In an emergency, care comes first.

Statutory health insurance

Emergency and stroke unit care are covered.

The ambulance service, emergency department, treatment on the stroke unit and the rest of the hospital stay are covered by German statutory health insurance. In Wertheim, the stroke unit is part of the Bürgerspital, a hospital with a public healthcare mandate.

The hospital’s discharge management team prepares the transition to rehabilitation together with you.

Private insurance or self-pay

Acute care is the same for everyone.

Billing follows the terms of private health insurance and Beihilfe (the German civil service healthcare allowance), or is settled directly with self-pay patients.

Privately insured patients are also treated on the same stroke unit. For the rest of their stay, they and self-pay patients can use the Main-Tauber-Klinik, the private clinic under the same roof.

Specialists

Your doctors at a glance.

On the stroke unit, neurology, internal medicine, specially trained nursing staff and therapists work together. Listed here are the Bürgerspital’s two neurologists; both are also part of the Main-Tauber-Klinik team.

  • Alexander NickelSpecialist in NeurologyWertheim
  • Dr. med. Sandra RückertSpecialist in NeurologyWertheim

Locations

Where treatment takes place.

Each clinic shows on its own website how the treatment works there.

Frequently asked questions

Good to know.

What should I do until the ambulance arrives?

Call 112 and say you suspect a stroke. Note the time the signs began or when the person was last seen without symptoms. Give them nothing to eat or drink, keep the upper body slightly raised and, if they are unconscious but breathing normally, place them in the recovery position. Have their medication list ready.

The signs have disappeared again – should I still call 112?

Yes. A transient ischaemic attack, or TIA for short, can precede a stroke; the risk is increased in the days that follow. The cause should therefore be investigated immediately, ideally on a stroke unit.

How long do patients stay on the stroke unit?

Usually only a few days. Exactly how long depends on the severity and cause of the stroke, on complications and on other conditions. After that, patients move to a general ward, go home or go to rehabilitation.

What does “local stroke unit” mean?

Baden-Württemberg classifies its stroke units into three levels: supra-regional centres, regional units and local units. The Bürgerspital is designated in the state hospital plan as having a local stroke unit. It provides stroke care close to home; catheter procedures are carried out by centres it works with.

Are brain haemorrhages also treated in Wertheim?

Yes. With a brain haemorrhage, the priorities are carefully lowering blood pressure and close monitoring, in intensive care if necessary. If surgery is needed, the patient is transferred to a neurosurgical hospital.

What happens after the stroke unit?

Many people need neurological rehabilitation to retrain movement, speech and independence. In the hospital building in Wertheim, the partner company Mediclin runs a neurological rehabilitation clinic. How far abilities recover varies from person to person.

How can a further stroke be prevented?

With well-controlled blood pressure, blood sugar and blood lipids, with exercise, stopping smoking and drinking little alcohol. Depending on the cause, medicines that inhibit blood clotting are added, for example for atrial fibrillation. This prevention already starts on the stroke unit.

Consultation

Personal consultation.

Describe your request – the right clinic will get back to you.

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