September 24, 2021 by John Fernandez
Telestroke Services Improving, Expanding at Baptist Health – Now to the Keys’ Mariners Hospital and Fishermen’s Community Hospital
With technology that continues to improve and a growing network of neurologists who can treat strokes during a critical window of time, Telestroke services at Baptist Health are now available to patients along the southernmost edge of South Florida: Mariners Hospital and Fishermen’s Community Hospital.
Patients with stroke symptoms have 24/7 emergency access to Miami Neuroscience Institute neurologists, who can best diagnose and treat the life-threatening condition via a specialized video cart with two-way communications that includes the patient’s diagnostic imaging and blood work results.
The evolving Telestroke technology is not new to Baptist Health. It’s been in use between the Institute’s specialists and attending physicians at other facilities or hospitals within the system for years. This year, Telestroke services are expanding beyond the technology by including onsite neurologists covering stroke alerts 24/7 at more Baptist Health locations.
With Telestroke, the neurologist from the Institute can even remotely control the camera at the patient’s bedside to evaluate the patient’s responses and focus on details, such as the pupils. The neurologist then collaborates with the onsite emergency team or neurologist to determine the best course of action. This may include the administration of a clot-busting drug and, or, emergency transfer for endovascular neurosurgery to physically remove the clot from the brain.
The American Stroke Association lists stroke as the No. 5 cause of death in the United States. To increase survival and limit long-term effects of a stroke, a patient has up to 4.5 hours from the onset of symptoms to receive intravenous alteplase, also known as tPA, to dissolve blood clots.
“This is technology that every year gets faster and more reliable,” explains Felipe De Los Rios, M.D., medical director of the Stroke Program at Baptist Health’s Miami Neuroscience Institute. “It allows us to do thorough evaluations. The main purpose is getting that expertise to the bedside in areas where there may not be a specialist onsite to provide 24/7 care.”
As soon as a patient with stroke symptoms enters the Emergency Department, the attending team issues a stroke alert and connects with an on-call neurologist at Miami Neuroscience Institute. “Stroke treatment is associated with significantly improved quality of life after a stroke, but the treatment has to be provided within hours of symptom onset in order to have the best chances of success,” adds Dr. De Los Rios.
The neurologist performs an evaluation that includes communicating and interacting with the patient, family members and onsite care team to get vital information, such as the precise time symptoms began to occur.
“We can bring the patient and family members into the room with a computer there and that way the neurologist can speak to not only the patient but any family that are there,” said Jessilyn Pozo, BSN, R.N., Baptist Health’s Stroke Program manager. “The neurologist can explain what’s going on, the risk and benefits of treatment, and they can discuss the imaging results. So, it’s pretty much as if the neurologist was there.”
Telestroke can also prevent the unnecessary transport of a patient several miles to the north – in the case of Keys patients – if the Institute’s neurologist deems transport not to be needed. “The Keys needed this service and it’s going to have a very positive impact,” says Dr. De Los Rios. “There’s a lot of people that don’t need to transfer and leave their community, which is always difficult for the patient and their relatives.”
Dr. De Los Rios adds that the Telestroke services allows Mariners Hospital to apply for Acute Stroke Ready Hospital Certification from The Joint Commission, which signifies excellence in the care of stroke patients. “This allows for more patients to be treated locally — without the need for costly emergency air transfers to larger hospitals in Miami,” he said.
Baptist Hospital, in partnership with Miami Neuroscience Institute, is one of a few hospitals in South Florida certified as a Comprehensive Stroke Center by The Joint Commission.
“Time is key when it comes to treating stroke patients,” said Dawn Hire, DNP, R.N., director of Nursing in the Emergency Department at Mariners and Fishermen’s Community Hospitals. “This technology is the fastest way to connect patients to a board-certified neurologist and is leading to better survival rates and improved patient outcomes.”