Cleveland Clinic expertise comes to Union Hospital
Photo courtesy of Union Hospital
The Telestroke Network places a Cleveland Clinic stroke specialist virtually at a patient’s bedside in the Union Hospital Emergency Room in Dover. Demonstrating how the system will work when it becomes fully operational in March are Bev Brown, an ER nurse, and Dr. Nathan Johnson, chief of emergency medicine at Union Hospital. Seen on the Telestroke screen is Dr. Muhammad Hussain, a vascular neurologist in the Cerebrovascular Center of the Cleveland Clinic. The mock patient is ER nurse, Wendy Ledger.
Union Hospital in Dover is collaborating with the Cleveland Clinic via the Telestroke Network, with a goal of enhancing patient care when there are no moments to spare.
“Time is tissue when it comes to preventing brain damage from a stroke,” according to Dr. Thomas Kelly, vice president of medical affairs at Union Hospital, who stressed that immediate treatment is critical to reducing paralysis and death after a stroke.
“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,” 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,” 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 connection between Union Hospital and the Cleveland Clinic is a two-way video conferencing system that includes a high-resolution television monitor, camera, and telemetry connections that rolls into position beside the patient's bed in the ER or ICU. Kelly said the response time to get the stroke specialist in live contact with the patient at Union Hospital 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 a CT scan is obtained.
The hospital’s CT scanner can 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, said he’s pleased that Union Hospital is joining the Clinic’s Telestroke Network.
Dr. Nathan Johnson, Union Hospital’s chief of the Emergency Medicine Department, said 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,’ which has the potential to dissolve a clot and stop tissue damage caused by a blocked artery,” Johnson said.
Johnson said 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.
Doctors Johnson and Kelly stressed that the key 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,” Johnson said. “We need to have the same awareness and quick action when it comes to signs of a stroke.”
He said the warning signs of stroke include the sudden beginning of:
• Numbness or weakness in the face, arm, or leg, especially on one side of the body.
• Confusion, trouble speaking or understanding
• Trouble seeing out of one or both eyes.
• Trouble walking, dizziness, loss of balance or coordination.
• Sudden or severe headache with no known cause.
“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,” 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. The goal is to complete training and get the Telestroke Network fully operational at Union Hospital by March 1.