AMBULANCE officers could soon be transporting suspected stroke victims directly to designated hospitals and administering drugs en route to reduce damage to the brain, as part of a radical attempt to slash the death and disability rate.
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More than 60,000 Australians suffer a stroke every year, including about 10,000 in NSW.
Stroke is the second highest killer after heart disease and the leading cause of disability among the elderly. But NSW has only 25 designated stroke units and no specialised treatment for patients taken to hospital by ambulance.
The program, in which triple-0 calls for stroke are given the highest priority and ambulance officers call ahead to clear the hospital's CT imaging room, has been operating in Los Angeles for 10 years and was presented at an international Stroke 2008 conference in Sydney yesterday.
The system was trialled at Gosford Hospital last September and proved so successful it was made standard practice, said the director of stroke services at Gosford and Wyong hospitals, Denis Crimmins.
"We were seeing about one patient a month for thrombolytic therapy [used to dissolve blood clots] but once we started this program, that rose to about two a week," Dr Crimmins said.
"We discovered that many ambulance officers had not been treating stroke as a medical emergency or did not recognise the symptoms.
"And there were communication delays between the ambulance service, the emergency department and the neurology department, meaning stroke patients were getting to us four to seven hours after their stroke and too late for thrombolytic therapy."
Jeffrey Saver, a professor of neurology and director of the stroke centre at the David Geffen School of Medicine at the University of California, Los Angeles, said the Los Angeles system had "put an end to the Russian roulette that patients face when they are taken to the nearest hospital".
"The time window for intervention in human brain ischaemia is all too brief. In a typical middle cerebral artery ischaemic stroke, two million nerve cells and 14 billion synapses die each minute. So the more people we can treat in the golden hour, the better the outcome," Professor Saver said.
The director of the stroke unit at St Vincent's Hospital, Dr Romesh Markus, said: "More than 80 per cent of NSW stroke victims who call triple-0 reach hospital within 60 minutes and 60 per cent within 45 minutes.
"We are not lagging behind the world at all but the problem is that only about 23 per cent of people will call an ambulance when they think they are having a stroke."
A NSW Ambulance Service spokeswoman said this year's intake of officers was being taught to recognise the signs of stroke.
