AcuteCare Telemedicine Blog

Recognizing the Symptoms of Stroke

While stroke awareness is a major concern for both men and women, a recent study concluded that women are less likely to recognize stroke symptoms. Only half of those surveyed know that sudden weakness or numbness on one side of the face, arms or legs is a warning sign of a stroke. 44 percent are aware that speech difficulty is a stroke sign while less than 1-in-4 could identify sudden severe headache, unexplained dizziness and sudden vision loss, or vision loss in one eye as the top symptoms of stroke. The study surveyed more than 1,200 women in the United States to assess their understanding of stroke’s warning signs.

The signs and symptoms of a stroke vary from person to person but usually begin suddenly. As different parts of the brain control different parts of the body, your symptoms depend upon the part of the brain affected and the extent of the damage.

The main stroke symptoms can be remembered with the word F.A.S.T.: Face-Arms-Speech-Time.

  • Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
  • Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
  • Speech – speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
  • Time – it is time to dial 911 immediately if any of these signs or symptoms at the earliest onset of these symptoms

For those living with or who care for somebody in a high-risk group, such as someone who is elderly or has diabetes or high blood pressure, being aware of the symptoms is even more important.

The acronym “FAST” is also meant to underscore the importance of rapidly delivering treatment to stroke patients. If given in time, a clot-busting drug administered during a stroke can lead to better outcomes and a decrease in the likelihood that a patient will suffer long-term disability. A recent study examined the effectiveness of tissue plasminogen activator (tPA) relative to the delay in administering this clot busting drug. Researchers found that every minute tPA was delayed cost nearly 2 days of disability free survival. The researchers commented that their message is literally “Save a Minute, Save a Day.”

Although many Americans live relatively close to a hospital where emergency stroke treatment is available, few actually receive the recommended therapies. Researchers found that only 4 percent of the more than 370,000 Medicare patients who suffered a stroke in 2011 were treated with tPA. Most stroke victims fail to recognize the symptoms of stroke or call 911 early enough to receive the necessary treatment. tPA is most effective when administered within a 4 hour window of time.

Every minute counts for stroke patients. Remember to act F.A.S.T.!

AcuteCare Telemedicine Turns 3!

This October marks the third anniversary of AcuteCare Telemedicine (ACT). Over the course of its first three years, ACT has grown considerably during a period of significant change in the policy and industry of healthcare in America. The 4 Board Certified partners of ACT have retained a steady focus on their mission of filling a growing need for 24/7 neurology coverage.

Telemedicine has proven to be a burgeoning facet of the healthcare industry, with technological advancements and enhanced communications allowing providers to extend their reach over geographical boundaries to patients in need while simultaneously streamlining the healthcare delivery process and reducing associated financial and environmental costs. ACT has worked hard to stay ahead of the curve, offering the most cutting-edge solutions for saving lives in cases of neurological emergency.

Entering its fourth year of providing this expert neurological consultation via telemedicine technology to rural and underserved medical facilities throughout the Southeast, ACT looks forward to continued growth. As teleneurology continues to garner attention from hospitals as a practical and effective solution to neurologist staffing needs, the outlook for the company this year and beyond is extremely positive. “The message of ACT has really started to take hold in the healthcare community, and as our efforts for finding new hospital partners ramp up, we are optimistic that we will ultimately be able to reach even more patients with and offer them the level of care they deserve,” says Dr. Lisa Johnston, Partner, ACT.

“Following our rebrand of the company in 2011, we have stayed dedicated to our values as expert practitioners and our vision as a business,” adds Dr. Keith Sanders, Partner, ACT. “The standard of service we have been able to provide has only climbed higher. We are truly passionate about combating morbidity and mortality rates of acute stroke, right here at home in the Stroke Belt (a region of the Southeastern US with higher-than average stroke rates) and beyond.”

Hard work and diligence is paying off for the partners of ACT. As the group continues to practice neurology full time and commit themselves to reaching more patients in 2013, they hope to add to an already impressive list of achievements and accolades throughout their short history.


Telestroke: Not Just About tPA

Acute stroke evaluation remains among the most frequently cited benefits of modern telemedicine technology. Known as ‘telestroke,’ the technology allows a neurologist at a remote site to reliably gather data by interviewing patients and family, performing physical examinations and reviewing brain imaging, directly impacting the course of a patient’s care. A recent article from Europe highlights that telestroke offers other benefits, tangible and intangible.

Stroke care in general at a hospital improves in several ways when telestroke consultations become available. Having a system in place to rapidly evaluate and treat stroke patients leads to faster and more accurate treatment of patients who need other brain treatments, such as clot extraction and neurosurgical intervention. Patients with stroke mimics can also be more rapidly treated. Telestroke leads to fewer unnecessary patient transfers, saving valuable time and money.

In stroke, care delayed is care denied. Getting stroke patients the immediate care they need at a local hospital rather than transferring them out leads to better outcomes and happier patients.

As hospital stroke volume increases, the staff gains experience and expertise in treating stroke cases. Stroke order sets provide a checklist to ensure that quality measures are being followed, and with increased experience comes increased use of such standards, which have been shown to improve stroke care. Even obstacles to physician staffing are addressed with telestroke experts on call. Doctors, as much as patients, prefer hospitals providing state of the art care.

In the hospitals we serve, the value of telestroke coverage resonates from the board room to the triage room. This is a technology whose time has come.


Certified Life Saving

For the last several years, the Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission) has monitored hospitals’ specific performance measures in treatment of common diseases. In 2011, stroke care joined pneumonia, heart failure, and heart attack on the list of monitored core diseases. Hospitals must demonstrate to the Joint Commission, and to the public, that they are providing good emergency stroke care in order to receive certification as a Primary Stroke Center. For instances of stroke, the Joint Commission monitors if hospitals are administering tPA (the clot busting medication) to eligible stroke patients.

Despite this focus on a high standard of care, large areas of the country lack hospitals who have administered tPA to stroke patients.  Alabama, for example, has only 3 hospitals certified as stroke centers. A lack of certified stroke centers has been shown to correlate with the rate of death from stroke. A primary factor in the failure to meet established standards is the limited number of neurologists available for emergency stroke intervention. The expanded use of telemedicine is a practical solution. Rapid evaluation by a stroke specialist via the internet enables the use of tPA in otherwise underserved areas, leading to better care and outcomes.

Rapid access to quality emergency care underlies the public’s confidence in our healthcare system. With limited numbers of neurologists and vast numbers of needy hospitals, telemedicine makes sense for stroke care.