TELESTROKE COLLABORATION WITH VALLEY HEALTH:

Sharing a life line

Video technology links hospitals to better diagnose suspected stroke victims

By Sally Voth — svoth@nvdaily.com

WOODSTOCK — A group of hospital personnel watched as a neurologist at Winchester Medical Center observed a possible stroke patient lying on a gurney at Shenandoah Memorial Hospital.

Dr. Patrick Capone gave the “patient” simple commands — raise her arm, smile, close her eyes — assessing her for signs of a stroke.

He was using the new telestroke service now available at SMH.

“We’ve been working on this for the past year,” said Lucas Wadsworth, a Valley Health administrative fellow.

Timeliness is critical when it comes to treating stroke patients, he said.

For patients having an ischemic stroke — in which a clot is blocking blood flow to the brain — tissue plasminogen activator, or tPA, which breaks up the clot, must be given with 41⁄2 hours of symptoms appearing, a Valley Health news release says.

It says 85 percent of strokes are ischemic.

“Stroke is the number one leading cause of disability in the U.S.,” Wadsworth said.

Winchester Medical Center stroke program coordinator Debby Massie stressed that strokes are treatable.

“There’s a myth within the community that if I have a stroke, there’s nothing they can do for me anyway, so why should I hurry, or they ignore symptoms,” she said.

Instead, they should immediately come to the hospital, preferably by ambulance, since the crew can call ahead to allow the emergency department to get ready, Massie said.
Upon arrival, the patient would have blood work done to see if he or she is a candidate for tPA, and a CT scan to rule out other causes of the symptoms, she said.

Using the portable interactive video conference technology and high-definition monitors, the emergency physician and neurologist on call at Winchester Medical Center would then assess the patient together, and the neurologist would determine if the stroke symptoms were severe enough to warrant the use of tPA, Massie said. The clot-busting drug does carry risks, including increasing the chance of bleeding elsewhere in the body.

Valley Health had 588 stroke patients in 2010 — 429 of which had ischemic strokes, Wadsworth said. The telemedicine program has the potential to improve the outcomes and quality of life for hundreds of people, he said.

“It has huge potential,” Capone said over the monitor. “It’s an extension of services that we’ve been doing with less access.”

Previously, neurologists were relying on telephone calls and scans from outer hospitals when recommending the use of clot-busting medications, he said, “but almost blinded, so to speak.”

“Its potential for all other areas of medicine is huge also,” Capone said. “It allows specialists to be other places they couldn’t be otherwise.”

Shenandoah County Department of Fire and Rescue training officer Billy Streett said the technology was a great enhancement. Suspected stroke patients are taken to Winchester Medical Center if it’s feasible, he said.

“For those incidences where we can’t get to the designated stroke center, this is an awesome option,” Streett said.

Dr. John Choi, a neurologist, lobbied to get the technology to the valley. He used telemedicine to administer tPA to patients in Texas before coming to the area.

“I have envisioned this for a couple of years,” Choi said. “I really think the next step is wheeling out this technology in the ambulance.”

Warren Memorial Hospital will start using the program in December, according to the news release, with Page Memorial Hospital in Luray, War Memorial Hospital in Berkeley Springs, W.Va., and Hampshire Memorial Hospital in Romney, W.Va., getting it early next year.

WARREN MEMORIAL HOSPITAL ROLLS OUT THE TELESTROKE PROGRAM 2/29/12!

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