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Stroke victims get instant access to overseas expertise

Top team: stroke specialists at KEMH can now benefit from outside expertise at the click of a mouse (Photograph supplied)

Stroke patients are first in line to be examined by outside specialists thanks to a new, high tech online treatment programme.

According to a Bermuda Hospitals Board spokeswoman, Primary Stroke Centre is one of the first facilities in the world to offer a transoceanic telestroke service. The service is provided through a collaboration with Johns Hopkins Medicine International.

The spokeswoman said: “Telestroke allows experts anywhere in the world to quickly examine a suspected stroke patient and make the time-sensitive treatment recommendation that can mean the difference between full recovery and permanent disability or death.

Dr Francene Gayle, BHB’s consultant neurologist and Primary Stroke Centre medical director, added: “BHB started a local telestroke service internally between Emergency Department physicians, hospitalists and local neurologists.

“In December 2020, the telestroke service became transoceanic, connecting with Johns Hopkins.

“Not even a pandemic stopped our teams from moving ahead with plans to advance the service. |

“We have up to five patients a week who come to the hospital having suffered a stroke whether there is a pandemic or not, so continuing to develop our services in the Primary Stroke Centre has been so important to the whole team working on this initiative at BHB.”

“This innovate way of managing stroke patients helps us collaborate in real time to care for our patients, despite being over 800 hundred miles apart,”

Dr Victor Urrutia, director of the Johns Hopkins Hospital’s comprehensive stroke centre, said: “Time is one of the most important factors in stroke treatment, so being able to collaborate remotely and make critical decisions about care makes a huge difference in outcomes for the individual patients.”

The local telestroke service began in June 2020, when about eight per cent of ischemic stroke patients received IV thrombolysis treatment – a “significant” improvement on the numbers given the drug before the centre launched.

After JHMI neurologists joined the local telestroke team in December 2020, the proportion of stroke patients who were administered the drug continued to rise to 13 per cent. The average for primary stroke centres in the US is seven per cent.

According to the BHB spokeswoman, the benefit is not just for those treated on island, but also for those who would benefit from treatment overseas.

Dr Gayle added: “Most recently, we had our first transoceanic transfer from BHB to a comprehensive stroke centre in the US for the removal of a large clot that had blocked a major blood vessel in the brain, a procedure called mechanical thrombectomy.

“Timing is critical in these cases, as the patient needs to be at the overseas hospital within 16 hours of the start of symptoms.

“BHB is engaging with the insurance companies to ensure that our air ambulance turnaround times are efficient in order for us to meet the transfer process within 16 hours,” said Dr Gayle. “We are quite thrilled about this.

“While this overseas relationship has clear clinical benefits, we have to stress the importance of recognising the need to get to hospital immediately if an individual thinks they have had a stroke.

“We have the clinical processes in place to act quickly, but this can only happen if people get to the hospital in time, so remember the BEFAST acronym – balance, eyes, face, arms, speech and time – to quickly identify and act on the early warning signs of a stroke.”

“We are honoured to collaborate with BHB to improve the care of stroke patients in Bermuda,” concluded Dr Urrutia. “The telestroke work we have done not only benefits people in Bermuda, but has far reaching implications for other remote area facilities.

“The experiences we gain through this collaboration can be shared globally.”

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Published July 31, 2021 at 7:55 am (Updated July 28, 2021 at 7:45 am)

Stroke victims get instant access to overseas expertise

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