Acute Bundle of Care for Intracerebral Hemorrhage


Intracerebral haemorrhage causes 1 in 10 strokes and has a far higher risk of death and disability than ischaemic stroke. The ‘ABC’ care bundle for intracerebral haemorrhage (ABC-ICH) was developed and implemented at Salford Royal NHS Foundation Trust (part of the Northern Care Alliance NHS Group) in 2015-16 and reduced 30-day deaths by one-third (35.5% to 24.2%). The bundle consists of guideline-recommended interventions:

  • Rapid Anticoagulant reversing
  • Intensive Blood pressure lowering
  • A Care pathway for prompt neurosurgical referral

The project originated following funding from the cardiovascular research domain within Manchester Academic Health Science Centre (MAHSC), now part of Health Innovation Manchester. On average, the lives of two Stroke patients have been saved every month since the Salford Royal Acute Stroke Unit team started using an innovative ABC care bundle and app following a project with Greater Manchester Connected Health Cities (GM CHC).

GM CHC’s app supports clinicians in delivering the components of care listed above to ensure that ICH Stroke patients receive the most effective and appropriate treatment. When the patients are in hospital, their data links to a dashboard so that the hospital teams can constantly monitor their condition and, if necessary, adjust their care accordingly.

Since the use of the ABC care bundle and app was implemented at Salford Royal, the number of deaths in the 30 days following an ICH stroke dropped by around one third. The ABC care bundle and GM CHC app are delivering real-world impact on the lives of people living in our region.

The ABC care bundle was scaled-up in Greater Manchester in 2017-18 and a phased scale-up across the North of England is also planned, supported by the ABC-ICH app.


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