January 28, 2020 by Ana Belzarena Genovese M.D.
Telemedicine Service in Coral Gables Rescue Vehicles to Help Stroke, Trauma Patients
The Coral Gables Fire Department will be the first fire rescue agency in Miami-Dade County to have a direct audio-video connection between rescue teams inside transport vehicles and medical specialists awaiting the patients’ arrival at Baptist Health’s Hospital Emergency Rooms.
For stroke or head trauma patients, responding quickly is especially a critical factor in providing the right treatment upon arrival at a hospital. The team of healthcare professionals at Baptist Hospital and Miami Neuroscience Institute gather facts quickly to determine if a stroke or head trauma patient can go into imaging, get clot-busting drugs or undergo life-saving surgery. (Simulation pictured above.)
For stroke patients, a very tight timeframe cannot exceed 24 hours from the onset of symptoms.
(Watch Now: The Baptist Health News Team hears from Guilherme Dabus, M.D., Chief of Neuroscience at Miami Neuroscience Institute and Miami Cardiac & Vascular Institute; and Xavier Jones, Coral Gables Fire Rescue Division Chief. Video by George Carvalho.)
“So every rescue transporting unit in the city of Coral Gables will have an iPad computer tablet in the back,” explains Xavier Jones, Coral Gables Fire Rescue Division Chief. “The trucks are equipped to do this with routers that are specific for this type of service. And it’s going to provide a great service to residents who will have a direct connection to a neurologist or a neurology team member. The quicker they get the specific treatment that they need, the better the outcome for the patient.”
This innovative “telemedicine” program will allow paramedics to consult directly with neurologists, trauma surgeons or other medical professionals through a secured video system.
About five years ago, Baptist Hospital was designated by the Joint Commission, which accredits U.S. healthcare organizations, as a “Comprehensive Stroke Center.” This designation means that a facility has the necessary resources — including advanced imaging capabilities and neurologists, neurosurgeons and interventional neuroradiologists — to treat the most complex stroke cases.
“For stroke patients, every second matters,” says Guilherme Dabus, M.D., Chief of Neuroscience at Miami Neuroscience Institute and Miami Cardiac & Vascular Institute. “Every opportunity where we can shave off time from the whole process and get this patient treated as fast as possible can potentially be the difference between a good outcome — with a patient going back to his normal life — versus a bad outcome.”
If patients arrive within 4.5 hours of onset of stroke symptoms, they can be treated with tPA medication, a clot-busting solution used to treat ischemic strokes — the most common type of stroke – and some patients may also need catheter-based procedures to remove the clot that is blocking the blood flow. The blood clot can cause serious complications, such as brain swelling, brain damage and can lead to considerable disability or death.
“A patient getting to the hospital could be a candidate for clot-busting medication,” explains Dr. Dabus. “But sometimes we need to provide more advanced treatments, such as catheter-based procedures to unblock vessels that are completely obstructed inside the brain. For all these therapies, tight timeframes are extremely important.”