May 22, 2019
Written by Ian Hunter, MD at Sheridan Memorial Hospital’s Internal Medicine
I’m often amazed by how little patients fear the thought of a significant health event such as heart attack. In contrast, the toughest rancher’s voice will quiver with terror when considering the idea of “living through a stroke.”
There are many different types of stroke, and the consequences of having a stroke can be devastating. Fortunately, the treatment of this common neurologic emergency continues to advance.
Recently Sheridan Memorial Hospital has joined in partnership with the neurologists of Wyoming Medical Center (WMC) to improve stroke care in Sheridan. Our Emergency Department is now equipped with a TeleStroke system which is activated when patients come in with stroke symptoms.
Neurologists from WMC can provide consultation for potential stroke patients any time of day or night. Through a specialized TeleStroke monitor, the patient’s history, physical exam, and neurologic imaging can be viewed real-time. The neurology stroke specialist then determines whether stroke “clot-busting” medications can be safely given and help our Emergency Department physicians decide whether patients should be transferred to another facility for additional procedures or admitted to our ICU locally. Additionally, WMC now offers interventional radiology guided blood clot removal for selected patients with large strokes, and the on-call neurologists help facilitate this process if needed.
One of the key predictors of a good outcome for stroke is how quickly treatment can be initiated. This partnership significantly improves the timeliness of treatment with neurology consultation, and several patient’s lives have been affected positively already.
Kelly Lieb, an Emergency Medicine Physician Assistant in the Emergency Department, cared for a patient with stroke symptoms recently.
“A male patient presented to the ER by ambulance and was identified by the paramedics as having a possible stroke,” Lieb said. “We were able to consult with Dr. David Wheeler from WMC via TeleStroke technology within minutes. He was able to view images, speak with the patient, and identify a treatment plan with us in real-time. In this case, we were able to treat the patient and manage the symptoms on an outpatient basis without admission to the hospital and without transfer to a higher level of care. In this case, we didn’t have to utilize the “clot-busting” medication, and this neurologic consultation assisted with that decision.”
David Nickerson, MD, an emergency medicine physician, states that approximately 20 people have come through the ER in the past four months where the TeleStroke system has been utilized.
“This is a very big deal for the safety of our patients,” Nickerson said. “I have had one patient whose care changed because of the WMC neurologist’s recommendations. They had an excellent outcome, and all their stroke symptoms resolved. This new TeleStroke system will continue to benefit our stroke patients.”