Wired for Faster More Effective Stroke Treatment

Dr. Duane Campbell & Dobin Testerman MSN, RN, of the LRMC Stroke Center

Stroke strikes fast. But technology is closing the treatment gap.

Technology entertains, organizes, mesmerizes, comforts and keeps us connected to the people we care about. Andnow that we’re able to carry it with us everywhere we go, technology has also become personal and instantly available.

But of all the ways technology has changed our lives, nowhere has it had a more dramatic impact than in its power to preserve health and save lives. A computer interface called TeleStroke is a prime example – one that’s helping stroke diagnosis and treatment catch up to the lightning-fast onset and effects of the fourth leading cause of death in the nation.

Enhancing Responsiveness

It has always been true that if a patient is exhibiting stroke symptoms or may have experienced a stroke, immediate care is necessary. Time can be the stroke victim’s worst enemy. The more time that passes, the more brain damage a stroke can potentially cause. At Lakeland Regional Medical Center, this has always been recognized and during off hours a neurologist has always been on call. But now with the technological enhancements provided by Telestroke, the neurologist can assess the patient remotely, before he or she arrives at the emergency department, thereby improving response times.

Fast diagnosis and treatment is particularly critical for a clot-causing ischemic stroke, the most common type. tPA (Alteplase), a medication that dissolves clots and restores blood flow, is routinely given within the first three hours of a stroke occurring if the patient is deemed a candidate for the drug.

How LRMC’s TeleStroke saves time – and lives

That same patient who may have had to wait for an on-call neurologist during a traditional treatment scenario can now be “seen” almost immediately upon entering the Lakeland Regional Medical Center Emergency Department. If a neurologist is not in the building, the patient is situated in front of the TeleStroke computer monitor, and the on-call neurologist views him or her from a home computer or laptop. The capability is a feature of the InTouch Health RP-Lite Remote Presence system, which is now being used at major U.S. hospitals. LRMC is the only hospital in the area to offer the advanced, FDA-licensed and secure ‘Skype-like’ form of visual communication between a stroke specialist and a possible stroke victim.

Dr. Duane Campbell, director of LRMC’s stroke program and a Watson Clinic neurologist, details the TeleStroke communication process.

“I address the family, explain what I’m doing and start the exam,” said Dr. Campbell. “I’m looking straight at the patient’s pupils. I can see any detail I want ... I ask the patients to do certain things in terms of (finding out) how strong they are and their ability to communicate.”

Several LRMC neurologists use the system in figuring out whether the patient truly has had a stroke and, if so, how serious the damage is. That can determine whether clot-busting medicine is the right approach to take.

This doesn’t mean neurologists don’t come to the hospital to treat the patient in person, said Robin Testerman, RN, the stroke program coordinator.

“Weekends and nights we want to have the same level of care available (as during the day),” Testerman said.

“I am living proof that TeleStroke works.”

Ronnie Lingerfelt, 63, lives alone at his home in Mulberry. On an early morning in January, he woke, unable to speak or use his right arm. After calling 911, he was rushed to Lakeland Regional Medical Center’s Emergency Department, where he was immediately seen by a neurologist – via TeleStroke. At this point, it was determined that he was having a stroke.

Dr. Campbell, the on-call neurologist when Lingerfelt arrived in the ER at approximately 2 a.m., used TeleStroke to assess Lingerfelt’s condition. He asked Mr. Lingerfelt to raise both arms, smile and state his name. These are typical questions asked by a neurologist to a potential stroke patient, but this time, Dr. Campbell was on the TeleStroke screen.

“When Dr. Campbell came on the screen, I thought, ‘these people know what they’re doing,’” Lingerfelt said. “I was talking to the doctor within a minute and didn’t have to wait; I was talking to him in real time.”

By evaluating Mr. Lingerfelt through TeleStroke, Dr. Campbell was able to quickly prescribe the clot-busting medication before arriving at the hospital to continue care. Lingerfelt felt better almost immediately and regained his ability to speak within a few hours after being administered the medication.

“I am living proof that TeleStroke works,” Lingerfelt said. “I love Dr. Campbell; he saved my life.”

Advanced stroke care advances peace of mind.

Lakeland Regional’s Stroke Center is the only stroke program in the area with state-of-the-art technology to treatstrokes beyond three hours. It was the first to use interventional devices such as carotid stenting and clot removal devices for acute stroke. Now, with TeleStroke, LRMC is able to further its mission of providing patients exceptional healthcare.

A multidisciplinary team comprises the Stroke Center at LRMC. Along with Dr. Campbell and Robin Testerman, this includes emergency department physicians, neurologists, interventional radiologists, intensivists and hospitalists. The dedicated stroke unit team adds rehabilitation specialists and nurses specially trained in cerebrovascular disease.

For more information on stroke, visit the Lakeland Regional Medical Center’s Online Health Library at lrmc.com. Research a disease or condition, take a health quiz or use one of our health calculators. You can also browse topics by category such as women’s health, children’s health or procedures. There is an A-Z list of topics as well to help you find the health information you are looking for.

Stroke patients and family members in need of encouragement, understanding or who just need to talk about experiences with stroke, can join LRMC’s Stroke Survivor and Caregiver Support Group. The class meets on the third Wednesday of every month from 2 to 3 p.m. The location is the Wound Care Center Conference Room at LRMC. For information, please contact Stroke Program Coordinator Robin Testerman, MSN, MBA, RN at 863-603-6526 or by email at Robin.Testerman@lrmc.com. The program is free, and registration is not required.