When it comes to treating a stroke, time is of the essence and mere minutes can mean the difference between recovery, disability or death.
In an attempt to avoid the latter results, Stanford Health Care-ValleyCare has made efforts to launch a comprehensive certified stroke care program, one of the first steps of the program being the acquisition of a TeleStroke Robot that is capable of rapidly diagnosing stroke victims.
"Stroke is so time-sensitive and that is the beauty of (TeleStroke). ValleyCare is a fantastic hospital, has fantastic physicians and now we can tap into the experts over (in Stanford) in an extremely time urgent matter. And basically get the best vascular neurologist from a top 10 hospital at a patient's bedside instantly," said Dr. David Svec, chief medical officer at Stanford-ValleyCare. "Most community hospitals don't have the ability to have a truly vascular trained neurologist 24/7, so this gives us a connection to the best."
Funded with donations gathered by the ValleyCare Charitable Foundation, the TeleStroke Robot works by connecting a specialist capable of quickly and accurately diagnosing a stroke with a patient suspected of having one, all via video.
Key to the technology is the amount of time it will save a patient in need of rapid diagnosis. Now instead of waiting for a specialist to travel to the regional hospital, a neurologist can analyze the patient and run the necessary verbal and visual tests to diagnose the condition remotely, saving crucial time in the treatment process.
The technology is adaptive and is capable of being equipped with additional tools such as a stethoscope for additional testing. In the future, TeleStroke may even be used to identify a wide variety of ailments and injuries, connecting patients with specialists of every stripe.
In a pinch it can even be used on a doctor's mobile phone through an accompanying app.
"In general every minute is important for us ... every minute we lose, you are losing the potential of getting someone back close to their baseline. The longer you go from the stroke onset to stroke treatment the higher the chances of disability," said Dr. Prashanth Krishnamohan, medical director of neurology at Stanford-ValleyCare.
Alteplase, the gold-standard drug approved by the U.S. Food and Drug Administration for stroke treatment, has an approved window of approximately three hours after a stroke has occurred. In certain cases this can be extended to about 4-1/2 hours, but this is a narrow window for detection with little room for error.
"If you look at the data only about a fifth of patients reach the hospital within this time for us to properly do the life saving treatment," Krishnamohan said. "So 80% of patients right off the bat we lose an opportunity to treat them."
The TeleStroke Robot will hopefully continue Stanford's exceptional stroke response time -- under five minutes, according to Stanford neurologist Dr. Christina Mijalski -- at ValleyCare as it expands its stroke care efforts.
"The joint commission recognizes TeleStroke as a very acceptable substitute for having an in-house vascular neurologist. In order to become a primary stroke center ... you just need to have a TeleStroke consultant available to you within 20 minutes or so," Mijalski said.
With a stroke occurring approximately every 40 seconds in the United States, physicians stress the importance of observers being able to identify the early signs and act quickly.
While it is paramount that an observer call 9-1-1 for accurate diagnosis and treatment, anyone can assist in early detection through the popularized BEFAST guidelines. Simplified, if someone is suspected to have a stroke, an observer will need to check their balance, eyes, face, arms, speech and time of occurrence, immediately calling 9-1-1 if suspected.
ValleyCare Charitable Foundation is funded primarily through individual donors and as of Nov. 23 has raised over $594,000 of the $1 million needed to fund the hospital's stroke care program.
To make a donation, learn more about BEFAST or ValleyCare's efforts to become a stroke center, visit valleycare.com/stroke.