“Though strokes can and do occur to people of any age, the risk of stroke increases with advanced age,” Mike Spiro, nurse manager, ER at MVH, said. “Given our aging population on the Island, strokes are quite common.” According to the CDC, “Strokes are the fifth leading cause of death in the United States. Every 40 seconds, someone in the U.S. has a stroke. And getting fast treatment is important for preventing death and disability from a stroke.”
TeleStroke teleconferencing can make all the difference in getting fast treatment for stroke victims. Spiro took us through how utilization of TeleStroke might work: “If a patient at home is having symptoms that could be a stroke, typically 911 is called, and we get a call from EMS saying we have a stroke alert. They’ll do a rapid stroke exam, and then check blood sugar and vital signs, then rush the patient to the ER. At the hospital, we’ll do a quick exam and get the patient right in for a CT scan of their brain. From the time the patient arrives at the hospital, they’re usually in a CT scan within 3½ to 4 minutes.”
Concurrently, as soon as the patient arrives at the ER, transportation is arranged in case the stroke victim must be transported to Boston by helicopter; the trip to Mass. General takes about 25 minutes.
“Once we’ve determined if the patient is having a true stroke or not, and if the patient requires a neurology consultation,” Dr. Alam Virk, director of ED (Emergency Department) at MVH, said, “we’ll get TeleStroke involved, because we don’t have a neurologist on staff at MVH.”
Because of Martha’s Vineyard Hospital’s affiliation with Partners Healthcare, the images from the CT scan are immediately sent to Mass. General. At MGH, the neurology team then uses TeleStroke to examine the patient.
“The neurology team contacts us via TeleStroke through a computer,” Spiro said. “The computer has a large screen, a speaker, and a camera on top that is controlled remotely … they can see the patient, ask questions, and do their whole exam via the computer being controlled by the neurology team at MGH. They provide direct guidance of our treatment.”
And because the team at MGH has access to EPIC, MVH’s common electronic medical record, the team has access to all the patient’s information — their scans, labs, history, and vital signs are all immediately available. “It’s as if the team is right here with the patient,” Dr. Virk said.
TeleStroke is an invaluable tool for smaller rural hospitals that may not have a neurological staff. “MVH used it 48 times in 2018 alone,” Spiro said. “It helps us provide the best, and most timely, care for our patients.”