For a stroke victim, every minute means brain cells. All the more reason to get the neurologist on the case as fast as possible – even if that doctor is hundreds of miles away.
With the newest telemedicine technology, Sonoma Valley Hospital can now deliver, fast, highly-specialized diagnoses and treatment for stroke. Within minutes of arrival, a patient can be observed by one of the Bay Area’s most skilled neurologists who can then assist in the immediate diagnosis and treatment.
SVH Chief Medical Executive Dr. Robert Cohen said this new capability helps the hospital provide the best possible outcome for patients undergoing an acute stroke.
“Time is brain,” agreed Jane Ren of California Pacific Medical Center, which provides the system. “The biggest value of the system is to make a neurologist available to people.”
Ren said the neurologists on the team are among the 1,000 neurovascular-trained neurologists in the country, and among only about 500 who actually take calls 24-7.
Wherever they are, in the mountains, at their laptop, or in their office at their computer, they can log on to activate the Polycom two-way audio-video system at SVH, and from that moment, have complete remote-controlled audio-video presence in the room.
“The neurologist may say, ‘You need to give her TPA, the clot buster medication, and transfer her to us immediately,’ or he may say, ‘You can keep her and administer the clot buster medication.’ It’s really important,” Cohen said, “that we have an expert in this process to look over our shoulder and say, ‘Yes, this is definitely the right thing to do for this patient.’”
He described how it works. “Say a 68 year-old woman comes in with stroke symptoms with complete paralysis of the right side of her body with inability to speak. Her symptoms have been present for 45 minutes. She comes into the ER and we immediately order a CAT scan of her brain and connect with the CPMC specialist, he looks at the images and, in real time, is able to recommend that we administer the clot-busting medication. He explained that the video part is a major advantage. The neurologist needs to be able to observe the Emergency Room Physician as he examines the patient.”
While this technology is a major advance, Dr. Cohen emphasized that the first line of stroke defense remains with the patient or family in being able to recognize the signs of stroke and get medical help immediately. He said there is a window of time – the first four and a half hours – in which the opportunity for success is optimal. “The sooner one seeks treatment, the more brain cells are saved,” he said. “So it’s important that we have the ability to assess and intervene within the first four hours.”
