A few years ago, former Bisbee, Arizona Mayor Jack Porter had a stroke that left him unable to talk or move his left leg or left arm. At Bisbee’s Copper Queen Community Hospital’s emergency room, a CT scan showed a clot forming on the right side of Porter’s brain. But there was no neurologist at the hospital. So the hospital sent the scan to a stroke specialist at the Mayo Clinic in Phoenix using GlobalMed virtual solutions. Porter was immediately treated with an injectable drug called tissue plasminogen activator (tPA) – and within 15 minutes, he was able to climb off his ER bed and walk around the room. Today he says, “I didn’t have a stroke. I had a stroke of luck.”
That’s the power of telestroke treatment right there – dramatic, immediate and life changing.
Virtual care is often lauded for its ability to triumph over location barriers, but its ability to eliminate treatment delays can be just as important. This is especially true with stroke care. From the moment a stroke begins, 1.9 million brain cells die each minute until blood supply returns to the brain. Real-time care is vital, but often rendered impossible by the physical distance between clinicians and patients. Telestroke transcends that distance to connect patients to swift and expert care –restoring their chance of a full recovery.
The Need for Immediacy
Strokes are the fifth leading cause of death in the United States. Almost 800,000 Americans experience a stroke each year; those who survive are often left with disabilities that end their former lifestyles and careers.
The good news is that immediate care can reduce the risk of long-term damage. Administered within a few hours, tPA can help reverse disability for ischemic strokes, which are caused by a blood clot traveling to the brain and blocking blood flow. When patients receive tPA within 90 minutes, they’re almost three times as likely to have favorable outcomes three months after their stroke.
Yet only 27 percent of stroke patients arrive at a hospital within 3.5 hours of their first symptoms. That hospital may not have a neurologist on staff; the U.S. has only four neurologists per 100,000 Americans. This means small or rural hospitals can’t always evaluate the patient’s stroke or the type of treatment needed, but a longer trip to a hospital with the right expertise and technology can lead to more damage.
Enter telestroke, which successfully eradicates these obstacles.
Expert Care in Every Community
Telemedicine connects patients and paramedics to world-class stroke expertise no matter where they’re located. Experienced vascular specialists, neurologists and stroke centers can view CT scans, perform the NIH Stroke Scale and determine the best therapy for the patient. They can advise paramedics to start tPA for ischemic strokes; if the patient has suffered a hemorrhagic stroke, where a burst blood vessel has interrupted blood flow to the brain, clinicians can provide guidance while the patient is transported to the nearest facility for thrombolytic therapy.
In one promising study of 2,500 patients who experienced an acute ischemic stroke, telestroke was able to radically change outcomes by:
- Increasing the timely use of clot-dissolving drugs by 75 percent
- Increasing the administration of the drugs by 11 minutes
- Accelerating diagnostic imaging tests by 12 minutes
- Expanding tPA administration by 55 percent in rural areas
Overall, the study found that telestroke was able to reduce door-to-needle time to less than an hour.
It’s important to note virtual benefits extend to both hospitals and patients. Telestroke can reduce the average length of hospital stays and expand neurology coverage, since one neurologist can serve multiple hospitals. Rural patients can stay in their communities and close to their families while receiving the same expertise as a patient staying in an advanced stroke center. Most importantly, they can increase their chances of living an active and independent life after a stroke. In a discipline where every second counts, telestroke can drastically change outcomes for everyone involved.