Technology brings stroke experts to Exeter

Monday, January 10, 2011

TeleStroke program launched in hospital’s emergency department

Originally published Friday, November 21, 2008

Exeter Hospital and Massachusetts General Hospital recently teamed up to bring the expertise of a nationally known team of stroke specialists from Boston to the bedside of patients in Exeter all without leaving the city.

Through a new program called TeleStroke, stroke experts at Massachusetts General are able to examine patients by using videoconferencing and image-sharing technology. The specialists can help diagnose the patient’s ailments and recommend a plan of care by talking to local doctors, nurses, the patient and studying brain scan images sent via computer.

“I can examine someone very interactively with the help of a physician or a nurse on the other end, and I can make a determination of the stroke severity and the type of stroke by looking at the patient and at the brain image,” said Dr. Lee Schwamm, a stroke specialist at Massachusetts General and one of the doctors participating in the partnership. “It’s almost like being in the room.”

One of the most significant aspects of the TeleStroke program is that it allows doctors at Exeter to administer Tissue Plasminogen Activator, also called TPA, a clot-busting drug that can greatly reduce the disability resulting from a stroke in certain patients. Eighty percent of strokes are ischemic strokes, an affliction in which a blood clot, formed in another part of the body, travels to a smaller blood vessel in the brain and becomes lodged, blocking the blood flow to that area. TPA must be administered within three hours of the onset of the stroke to be effective.

“The TeleStroke program will provide a real-time, face-to-face interaction with a neurologist who is able to assist our local emergency room doctor with examining the patient and helping to make a determination about whether the patient is a candidate for TPA,” said Dr. Philip Voss, an emergency department doctor at Exeter. “This enables our local emergency room doctors to consult with that neurologist sooner than a local neurologist could be called in locally to help evaluate the patient and sooner than a patient could be transferred to Boston.”

When a stroke patient is brought to Exeter’s emergency room, a television monitor is wheeled into the exam room, and within minutes, one of the participating stroke specialists from Massachusetts General is live on the television screen. That doctor receives a copy of the brain images for the patient, giving the stroke specialist a chance to be able to see subtle findings in a stroke patient that might not be seen by a less experienced eye.

“For our nurses and doctors, having access to the stroke experts at Massachusetts General Hospital, is invaluable to us as we care for patients of the hospital,” said Laura Wilhelm, a registered nurse at Exeter. “As a nurse, I feel like this gives us a powerful tool to help us as we provide the best possible care for our stroke patients within their own community.”

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