Telestroke


When you experience a stroke, minutes count. This is particularly true for people who live in rural areas and who may live a distance from their local medical facilities. Lost time can mean loss of brain function. This is why Jefferson Healthcare Hospital has partnered with Swedish Medical Center, in Seattle, to give Jefferson County residents the best chance to survive and recover from a stroke.
 
With our rapid response stroke protocols, Jefferson Healthcare is prepared to quickly assess a potential stroke patient, consult with a neurologist at Swedish Medical Center via telemedicine and to deliver the proper medications before transporting patients to Swedish Medical Center’s stroke unit.
 
Jefferson Healthcare is the first hospital in the area to establish a stroke team. One of the advantages provided by our partnership with Swedish is that the arrangement allows for easy transfer of Jefferson Healthcare patients into the Swedish system.
 
Here’s how our program works
If emergency medical services responds to a call and suspects that the patient is experiencing a Transient Ischemic Attack or stroke, a series of standardized activities is put into motion: 
  • The medics perform a quick stroke assessment recommended and endorsed by the American Heart/Stroke Association, the American Academy of Neurology, and the American College of Emergency Physicians.
  • Medics confer with the Jefferson Healthcare Emergency department physician. Based on the evaluation, a Code Stroke is called, if necessary.
  • The Code Stroke notifies the internal team and causes the laboratory and computerized tomography (CT) services to shift to a stroke priority status.
  • An IV is started in the ambulance and blood is drawn and prepared for the lab.
  • Stroke team members meet the paramedics when they arrive.
  • The blood draw is transferred to the lab as soon as the patient arrives.
  • The nurse orders the necessary radiology exams (CT and chest X-ray).
  • The Emergency physician does a detailed neurological exam, following the National Institute of Health Stroke Scale.
  • The physician will have the lab and CT results within 45 minutes and will make a decision about whether the patient has indeed suffered a stroke. If this is the case, the physician also will determine whether the patient is eligible for clot-busting thrombolytics or requires definitive care at a tertiary hospital.
  • During the 45-minute period, a telemedicine consult with the neurologist at Swedish takes place.
  • If the patient is eligible, the clot-busting thrombolytic drug is administered (see “About Clot Busters”).
  • After the thrombolytic is administered, the patient is transferred to Swedish Medical Center.