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Telestroke

Stroke is the third leading cause of death in the United States and a leading cause of disability. A stroke occurs when there is impairment in the blood flow in or to the brain resulting in a variety of neurological deficits. Each minute that an acute ischemic stroke goes untreated, 1.9 million neurons die. Major advances have been made during the past several decades in stroke prevention and treatment.

Flagstaff Medical Center (FMC) has partnered with Mayo Clinic to bring more specialist expertise to the patients through novel means. In what is referred to as telestroke patient assessment and management, stroke cases present to the emergency department at Flagstaff Medical Center and undergo a remote stroke assessment by a vascular neurologist at Mayo Clinic. Special audiovisual equipment transmits information in real-time between FMC and Mayo Clinic. The vascular neurologist remotely interacts with patients, their families and emergency department staff and is able to observe diagnostic head imaging, cardiac monitors, and patients’ performance on a structured neurological examination. The vascular neurologist, informed of all pertinent information, then advises the emergency department physician whether to administer the drug tPA. This drug must be given within three hours of the onset of symptom to patients that have ischemic strokes, Mayo Clin Proc. January 2009; 84(1):3-4.

These types of remote consultations are happening here at FMC allowing for rapid assessment and treatment of ischemic stroke patients. Prior to such technology, patients were often transferred to other stroke facilities in the southern portion of the state delaying treatment. This is no longer the case.

In 2010, FMC and Mayo Clinic saw 84 people using remote monitoring. All of these patients were able to receive rapid specialist assessment and care and avoid any delay in treatment. They also avoided the unnecessary transfer and expense to another hospital.