"Time is tissue when it comes to preventing brain damage from a stroke."
Dr. Thomas Kelly, vice president of medical affairs at Union Hospital says immediate treatment is critical to reducing paralysis and death from stroke. That's why he welcomes the hospital's collaboration with the Cleveland Clinic in the Telestroke Network.
The Telestroke Network places the Cleveland Clinic stroke specialist right at the bedside of the patient in the Union Hospital ER. Demonstrating how the system will work when it begins in March are Bev Brown, RN, an Emergency Department nurse and Dr. Nathan Johnson, chief of emergency medicine at Union Hospital. On the Telestroke screen is Dr. Muhammad Hussain, a vascular neurologist in the Cerebrovascular Center at the Cleveland Clinic. The model patient is another ER nurse, Wendy Ledger, RN.
"When the system is fully operational starting March 1, stroke care at Union Hospital will be enhanced by the virtual presence of a neurologist or neurosurgeon from the Cleveland Clinic," Dr. Kelly said. "The Clinic doctor will use tele-medicine technology to see and speak to the patient and family, conduct the examination with the ED physician and nurse, and help select the most effective treatment."
"Time is critical to stopping a stroke and preventing loss of function or death," Dr. Kelly explained. "On average, 15 to 20 people in Tuscarawas County suffer some form of stroke each month. The Telestroke Network has the potential to benefit many of those patients, but only if stroke symptoms are recognized and the patient brought to the ER within a few hours of the start of the symptoms."
The stroke specialist from the Cleveland Clinic will be available at the patient?s bedside in the Union Hospital ER within minutes of being called. High resolution cameras and monitors enable physicians and nurses to work together to diagnose and treat the stroke patient. Dr. Muhammad Hussain is one of 22 stroke specialists who staff the Cerebrovascular Center at the Cleveland clinic 24 hours a day, 7 days a week.
The connection between the Union Hospital ED and the Cleveland Clinic is a 2-way video conferencing system which includes a high resolution television monitor, camera, and telemetry connections that rolls into position beside the patient's bed in the ER or ICU. Dr. Kelly says the response time to get the stroke specialist in live contact with the patient at UH will be as little as five minutes from the time the call is placed to the Cerebrovascular Center by the ER staff. That call is made after the ER physician has evaluated the patient and the important CT scan is obtained.
The CT scanner at Union Hospital is equipped to immediately send the patient?s brain scan images to the Cleveland Clinic stroke specialist to assist with the diagnosis and treatment decisions.
Peter Rasmussen, M.D., director of the Cerebrovascular Center at Cleveland Clinic, welcomed Union Hospital into the network of Telestroke hospitals.
I am very pleased that Union Hospital has taken the initiative to join the Cleveland Clinic Telestroke Network, said Dr. Rasmussen. "This is a clear indication that Union Hospital wants to make the very best stroke treatment available to its patients and offer them the greatest opportunity for the best possible outcome."
Dr. Nathan Johnson is chief of the Emergency Medicine Department and says the Telestroke Network will expand the window of time available to limit the damaging effects of a stroke.
"We'll have more opportunity to use a drug called tissue plasminogen activator, or TPA", Dr. Johnson said. "TPA has the potential to dissolve a clot and stop tissue damage caused by a blocked artery."
Johnson says other patients will require immediate transfer to the Cleveland Clinic, a world-class neurological center, for more aggressive therapy to remove the clot or for surgery to repair a broken vessel in the brain.
"I'm very excited for our ability to more effectively care for stroke patients," Dr. Johnson said. With the neurologist at our side via the Telestroke Network, the patient will receive the same care here as if they were at the Cleveland Clinic's ER."
Both Dr. Johnson and Dr. Kelly say the key to gaining the most benefit from Union Hospital?s participation in the Telestroke Network is getting patients to the Emergency Department as soon as possible.
"Most people have learned to recognize the signs of a heart attack and know to come for treatment immediately. We need to have the same awareness and quick action when it comes to signs of a stroke," Dr. Johnson said. He says the warning signs of stroke include the sudden beginning of:
"Your greatest opportunity to survive a stroke and limit disability is to call 9-1-1 and seek emergency treatment at the first sign of any stroke symptoms," Dr. Johnson added.
Emergency physicians and nursing staff are currently undergoing Telestroke Network training to become proficient in using the technology in conjunction with the stroke specialists at the Cleveland Clinic. That training is being implemented by Carol Murphy, RN, Director of Quality Improvement and Rebecca Craig, RN, an Emergency Services Manager.
Murphy says the goal is to have training completed and the Telestroke Network fully operational at Union Hospital by March 1.