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About Stroke

“Stroke code” i.e. a rapid-response system which improves timeline in delivery of intravenous tissue plasminogen activator (TPA) is available in RUBY HALL CLINIC. A stroke occurs when blood flow is interrupted to part of the brain. Lack of oxygen and nutrients cause brain cell death. Depending on the region of the brain affected, a stroke may cause paralysis, speech impairment, loss of memory and reasoning ability, coma, or death. A stroke also commonly known as called a brain attack or a cerebrovascular accident (CVA).

Risk Factors for Stroke: Age, sex, heredity, predisposing diseases or other medical conditions, use of certain medications, and lifestyle choices.

Stroke Is A Medical Emergency Requiring Immediate Treatment: A person who may have suffered a stroke should be seen in a hospital emergency room without delay. Treatment to break up a blood clot, the major cause of stroke, must begin within four & half hours of the stroke to be effective.

Timely intravenous thrombolysis for acute ischemic stroke is associated with better clinical outcome. “Stroke code” (SC) may improve the timeline in the delivery of intravenous tissue plasminogen activator (tPA).

Ruby Hall Stroke Unit (NTU)

A NTU is a 6 bedded dedicated, geographically clearly defined area where stroke patients are admitted and managed by a multidisciplinary team (medical, nursing, and therapy staff) who have specialist knowledge, training, and skills in stroke care with well- defined individual tasks, regular interaction with other disciplines, and stroke leadership. We have 24 hrs back up of neurologist & radiologist.

Responsibilities of Stoke Code Team

  • Neuro assessment by neuro physician and EMS personnel
  • Early diagnostic investigation
  • Stroke specific therapeutic intervention
  • Start secondary prevention
  • Early mobilization
  • Rehabilitation process


Improving timelines from pre code era to post code till 2019 June

 Pre code era
N =659

 Post SC 
(2016) N=243

 Post SC 


 2019 till June
N= 216


Percentage of patient thrombolysed 6.3% 
(44) 11.52 %
(28) 9.4 %
(26) 7.5%
(26) 12.5%
(27) 15-18%
Thrombolysis rate
<60 mins 15.90% 53.51% 67.51% 70.1% 55.56% >50%
Door to physician time(min) 32.93 5 7.15 4.8 4.7 10
Door to imaging time(min) 58.88 23 21.3 20.5 22.5 25
Door to needle time (min) 104.95 84 48.1 56.5 60.3 60