When it comes to stroke, time is brain; making speed a critical component of treatment. As part of a new telemedicine program implemented in all four Lee Memorial Health System acute care hospitals, stroke care has been expedited, decreasing door to needle times – the interval between patients’ arrival to the hospital and the start of treatment.
With a telemedicine program in place, neurologists who are off site can now evaluate patients in the emergency department (ED) that present with stroke symptoms and offer remote consultations. They can make a diagnosis and treatment recommendations to the ED staff through the use of high-quality, interactive technology involving real time access through digital video cameras, monitors, the internet, and other teleconferencing equipment. A prompt evaluation reduces diagnostic delays and speeds the delivery of tPA (clot-busting drugs), which can greatly diminish stroke related disability and death.
The telemedicine program works like a well-oiled machine involving physicians, radiology technicians, nurses, and other staff. As a suspected stroke patient arrives to the ED, they will typically undergo a CT scan. During this time, the emergency room physician alerts the neurologist on call and gives a brief overview of the patient’s condition as a tech sets up the tele-health cart in the patient’s room.
CT scan results are available quickly allowing the neurologist to review them as the patient returns from the scan. Rather than driving under stress and racing to the hospital, neurologists can now begin evaluating a patient and making an assessment from the calm and comfort of their home, office, or wherever they happen to be when the call comes in.
After assessing the available information, the neurologist is virtually present via the tele-health cart the tech placed in the room, and leads the care team through evidence-based protocols to provide an optimal outcome given the patient’s unique set of circumstances.
Cape Coral Hospital’s Emergency Department team was the first in Lee County to use telemedicine to treat a stroke patient. As designated Primary Stroke Centers (Cape Coral Hospital and Lee Memorial Hospital) and a Comprehensive Stroke Center (Gulf Coast Medical Center), Lee Memorial Health System’s hospitals already deliver swift, leading-edge and effective treatment available every day around the clock.
Stroke is a leading cause of long term disability and death in the United States, killing nearly 130,000 Americans each year—that’s one of every 19 deaths. This new approach has the potential to reducing the burden of stroke disability in our community by improving the level and speed of care the team is able to provide.
If you think you or someone else is having a stroke think F.A.S.T.:
Face. Ask them to smile and look for drooping on one side of the face.
Arms. Ask them to raise both arms and look for weakness or inability to lift.
Speech. Ask them to repeat you and listen for slurred or strange speech.
Time. During a stroke every minute counts. If you observe any of these signs, it’s very important to call 911 and get help immediately. All too often people lose valuable time because they are in disbelief or they wait hoping to feel better. Don’t wait and don’t drive yourself to the hospital. Emergency services can begin to assess your condition and communicate with hospital staff to expedite care when you arrive.
Bill Carracino, M.D., has served more than half of his 25 year career in Fort Myers, and was the first neurologist in Lee County to use telemedicine to treat a stroke patient. He is also the chief medical informatics officer for Lee Memorial Health System