New VVMC program 'stops the clock' on strokes

‘Time lost is brain loss’ during stroke

Called the Stroke Doc, the system is part of the STARR network, Stroke Telemedicine for Arizona Rural Residents. The Arizona Telemedicine Program, established by the legislature in 1996.

Called the Stroke Doc, the system is part of the STARR network, Stroke Telemedicine for Arizona Rural Residents. The Arizona Telemedicine Program, established by the legislature in 1996.

COTTONWOOD -- Thanks to innovation and collaboration, Verde Valley Medical Center is able to take advantage of a underutilized procedure that allows physicians to break up a blood clots responsible for a stroke. And it is also taking advantage of Arizona's entry into telemedicine.

A stroke is a change in the blood supply to the brain, too much or too little. The events are the leading cause of disability in adults and the second leading cause of death in the world.

When blood flow is changed or interrupted to the brain, there is a loss of brain cells, as many as 2 million brain cells each minute, according to Neurologist Dr. Ian Livingstone.

About 80 percent of all strokes are the result of a blood clot. The other 20 percent are the result of a ruptured blood vessel.

A number of years ago, a process was developed to break up blood clots that cause strokes, but the process has not been widely used.

The "clot-buster" treatment is technically named thrombolysis, "the breakdown of blood clots by pharmacological means." The protein involved is a Tissue Plasminogen Activator (tPA).

It is another of those wonder drugs, but it must be used with caution and under specific guidelines or its use can produce additional problems. There is a 6-percent complication rate and a very small window of time in which the drug may be administered.

Dr. Livingstone at the Verde Valley Medical Center says, "It is underutilized because it is hard to determine when its use is appropriate." The assessment needs a physician like Livingstone, the only neurologist at the medical center. But he can't be on call around the clock.

"This is not a designated stroke center like Mayo Clinic and Barrows Neurological are. Guidelines are very important and it is critical that the appropriate safety checks are in place," said Dr. Livingstone.

But, because the tPA process is so useful, the Mayo Clinic now established a system that allows a patient's condition to be determined remotely.

Enter the "robot." It looks like a robot might, a device that stands on wheels, a display on its chest and a camera for a head. It is not really a robot in the truest sense of the word, but more like a computer on wheels that allows a local hospital like VVMC to interface with a 24-hour on-call stroke specialist at Mayo.

The system has an interface that allows the Cottonwood hospital to put a patient's data directly online to be assessed by the Mayo specialist. The camera also gives the doctor at the remote end a live picture of the patient with a lens so powerful that it can detect pupil area response and monitor on-going tests in real time.

Called the Stroke Doc, the system is part of the STARR network, Stroke Telemedicine for Arizona Rural Residents. The Arizona Telemedicine Program, established by the legislature in 1996.

It gives the local hospital another leg up in dealing with one of the most common "brain attacks."

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