April 20, 2012
KCH Stroke Telemedicine Pilot Program Underway with UPMC Hamot
A new and potentially life-saving technology is now being piloted at Kane Community Hospital’s Emergency Room. KCH’s affiliation with UPMC Hamot makes this pilot possible.
“It’s called the stroke telemedicine program,” stated KCH ER Nurse Manager Cindy Salerno, RN, CEN, PHRN. “What that means is, when a patient comes to our ER with stroke-like symptoms, our ER doctor and nursing staff, and more importantly the patient, will be able to consult directly with a neurologist at UPMC Hamot in Erie."
"When an acute stroke patient arrives at the KCH ER, and the ER physician determines a call to UPMC Hamot is indicated, the call is made and a neurologist is dispatched to a specialized office to begin an assessment of the patient," Mary Parana, RN, ADON, Director of Outpatient Services at KCH noted. "This is possible because of mobile monitoring equipment that allows the stroke patient to be seen and be assessed by the neurologist with video camera and monitor at both Kane and Erie, so the ER physician, consulting neurologist and patient are able to see and hear each other."
A specialized stethoscope can be used on the patient, which allows the neurologist to hear the patient’s heartbeat from his office in Erie as well as if he or she were in the room.
"This type of assessment is important because with an acute stroke, time is critical. Patients need to be assessed by a specialist who has the expertise and who can help develop treatment options. Unlike when patients have a heart attack, and physicians in an ER can use an EKG machine to diagnose what is going on, diagnosing a stroke usually involves actually looking at the patient and talking to them. After the neurologist completes the examination, they consult with the ER physician and the patient’s primary care provider to decide the best course of action. In some cases, the patient can remain close to home and will receive treatment at KCH. Other times, it may be critical that the patient is transferred to UPMC Hamot for more specialized treatment," Salerno stated.
The telemedicine pilot program launched on Monday, April 16 and is available from 9 a.m. until 5 p.m. Monday through Friday. It is the hope of both KCH and UPMC Hamot to eventually expand those services to be available 24/7.
Part of the pilot process involves the training of KCH ER nurses in the acute stroke evaluation process as well as building skills in the technology and equipment used in the exam to enhance the electronic exchange and ensure the consulting neurologist and patient have a full view of one another.
Who is at risk for Stroke?
There are a number of risk factors that could increase the likelihood of someone suffering from a stroke. Being 55 years or older, having high blood pressure or high cholesterol, or suffering from cardiovascular disease are all classic risk factors. You’re also a candidate for stroke if you smoke cigarettes or have diabetes. Being overweight puts you at risk, as does physical inactivity. Heavy or binge drinking or the use of illicit drugs—like cocaine or methamphetamines, increases your chances for a stroke.
The most common symptom is a sudden and severe headache, which comes out of the blue. Another sign you may be having a stroke includes trouble walking – usually this means stumbling or sudden dizziness or loss of balance. Trouble speaking – or understanding people talking – is another sign. Some patients find they’re unable to find the right word to explain what is happening to them. A good check is to try and repeat a simple sentence. If you can’t, you may be having a stroke.
Paralysis or numbness on just one side of your body or face may also develop. In these instances, try to lift both of your arms over your head. If you find that one arm begins to fall, seek medical attention. Additionally, one side of your mouth may droop when you try to smile. Some stroke patients complain about trouble seeing out of one or both eyes because of either blurred or blackened vision or seeing double.
If someone is experiencing any of these symptoms, they should call 911 and seek immediate medical attention.
The sooner a stroke patient seeks treatment, the better their outcome may be. The longer a stroke goes untreated, the greater the risk for possible brain damage or disability. In some cases, symptoms fluctuate or disappear. This is NOT a sign that you’re okay and do not need to be seen by a doctor. You should still call 911 so you can be taken to the ER. A good rule of thumb is to get to the hospital within an hour of the appearance of your first symptoms.
"Now, through KCH’s affiliation with UPMC Hamot, patients fearing that they are suffering from a stroke can receive the specialized diagnosis of a UPMC Hamot neurologist consult and the care they need at the Kane Community Hospital ER," Parana said.
The Stroke Telemedicine program, now in pilot, follows successful use of Telemedicine for cardiology consults at KCH.
Neurologist Daniel J. Kinem, DO (pictured on the monitor and at UPMC Hamot) is listening to the heart of his colleague Neurologist James A. DeMatteis, MD in the KCH ER for the test telemedicine transmission and ER nurse in-service training session in preparation for the start of pilot.
Far left, Director of Outpatient Services Mary Parana, RN, (holding folder), Cindy Salerno, RN, CEN, PHRN (seated) and ER Nursing Staff with Neurologist James DeMatteis during in-service.
ER Nurse Manager Cindy Salerno (posing as stroke patient, seen on the monitor) with Dr. DeMatteis and ER nursing staff in training session. Here they walk through a stroke assessment of patient with Dr. Kinem (visible on screen upper right) in Erie and Dr. DeMatteis at the KCH ER.