Telestroke: Care when it counts

When a person is having a stroke, every second matters. Now, there’s new technology to help physicians diagnose and treat stroke patients as quickly as possible.

Telestroke technology electronically connects doctors and patients by allowing them to video conference with one another in the crucial moments following a stroke.

“Many people are familiar with FaceTime and Skype now, and this is just a version, but for medical care,” explains Dr. Raymond Reichwein, co-director of Penn State Hershey Stroke Center, director of the LionNet telestroke program, and associate neurology professor.

Reichwein says staff at a different facility – usually one in a more rural area, or a hospital without neurology specialists on-call 24/7 – will make sure the patient quickly undergoes the necessary tests before calling a Penn State Hershey physician to weigh in.

“Once we sign on, we quickly look at the CAT scan. We look at the time frames. We assess how severe the patient is. Is it consistent with an ischemic stroke, or a stroke, period? And then we decide what the best treatment intervention is for that patient.”

But Reichwein says using telestroke is more advanced than simply video chatting; it permits physicians to have access to lab results, imaging reports, and other information crucial to diagnosing a patient.

“As part of our interaction, I can look at the actual patient image, so the actual brain image of that patient via the laptop, so I can see exactly what the hospital system there can see. So not only have I talked to the patient and the family, examined the patient with the help of the staff there, looked at their imaging, again, I have full control and assessment over the entire patient process.”

Reichwein adds it’s especially important to ensure a stroke patient gets necessary medication in a timely fashion – and telestroke can help make this happen.

“For stroke care, the first few hours are critical, particularly focused on a clot buster called tPA (tissue plasminogen activator). That’s still the mainstay for most types of strokes, particularly ischemic strokes, to where a clot blocks up a blood vessel. The sooner you get it, the better you do with the least complications. And it has to be given within 3 to 4 and a half hours from the symptom onset.”

In fact, Reichwein says at many of the facilities Penn State Hershey Medical Center partners with, telestroke allows physicians to diagnose and treat stroke patients within one hour to 90 minutes of their arrival at the emergency department.

Overall, Reichwein says telestroke levels the playing field for patients, connecting them to top-quality stroke care wherever they happen to be.

“There’s a significant shortage of neurologists and neurosurgeons in the community hospital systems, let alone ones that have expertise or comfort levels in stroke care…Essentially what we’ve done is provide access via technology for patients and families to get experts 24/7 in their own community just with a phone call and a computer system.”

How to tell if you or a loved one is having a stroke:

Dr. Reichwein says to determine if a medical event is, in fact, a stroke, consider this acronym:

F.A.S.T. – Face, Arms, Speech, Time

“Is there facial weakness or facial droop or numbness? Arm weakness or numbness of the arm? Is [there] a problem with your speech, problems articulating words, understanding or slurred speech? ‘T’ is time and [represents] the importance of calling 911.”

Reichwein says in the event of a stroke, 911 should be called as soon as possible.

A note of disclosure: Penn State Hershey Medical Center underwrites content on this website.