Increasing Access to Quality Stroke Care
People who suffer a stroke, or believe they may be experiencing a stroke, need help fast. The faster a patient can access specialized stroke care, the better their chance of recovery. Getting to a hospital as quickly as possible is extremely critical. Not everyone, however, lives close to a hospital where specialized care is available. Labrador-Grenfell Health is working with several partners provincially and nationally to standardize and enhance stroke care services for residents of Northern Newfoundland and Labrador. The result is a Telestroke Strategy which uses advanced technology to increase access to quality stroke care.
The following information provides an overview of stroke and outlines the key elements of a Telestroke Strategy adopted by Labrador-Grenfell Health.
What is stroke?
People who suffer a stroke, or believe they may be experiencing a stroke, need help fast. The faster a patient can access specialized stroke care, the better their chance of recovery. Getting to a hospital as quickly as possible is extremely critical. Not everyone, however, lives close to a hospital where specialized care is available. Labrador-Grenfell Health is working with several partners provincially and nationally to standardize and enhance stroke care services for residents of Northern Newfoundland and Labrador. The result is a Telestroke Strategy which uses advanced technology to increase access to quality stroke care.
The following information provides an overview of stroke and outlines the key elements of a Telestroke Strategy adopted by Labrador-Grenfell Health.
What is stroke?
- Stroke is caused by an interruption of blood flow to the brain tissue due to a clot or a rupture of the blood vessels of the brain.
- Without blood, brain cells die. Since two million brain cells die each minute during a stroke, the risk of disability and death increases as time passes.
- Almost 85% of strokes are caused by a blood clot in the vessels supplying blood to the brain.
- Numbness or weakness on one side of the body or face.
- Difficulty speaking
- Blurred vision
- Sudden headache
- Dizziness or weakness
- If you experience any of these signs or symptoms, call the ambulance immediately.
- Paramedics have been trained to assess and identify the signs and symptoms of stroke.
- They can transport you to the nearest stroke centre.
- Under the direction of Provincial Medical Oversight (Paramedicine Medical Transport) and in consultation with the Provincial Stroke Strategy, a Stroke Direct Transport Protocol was implemented.
- In consultation with a physician through Online Medical Oversight, paramedics may bypass the nearest health care facility to transport a patient to a designated stroke centre as quickly as possible.
- Charles S. Curtis Memorial Hospital, St. Anthony
- Labrador Health Centre, Happy Valley-Goose Bay
- Captain William Jackman Memorial Hospital, Labrador City.
- A full emergency assessment may involve a CT scan and, if appropriate, administering a clot-busting drug called tissue plasminogen activator (tPA).
- This drug must be given within a few hours of the onset of symptoms. When stroke is caused by a blood clot, treatment with tPA can reverse the effects of stroke.
- Telestroke is the use of telemedicine specifically for stroke care.
- Advanced videoconferencing technology and cameras extend the reach of the country’s stroke experts to remote communities.
- Neurologists and radiologists in larger centres can now assist physicians in rural hospitals with the decision of whether or not to administer tPA.
- Telestroke allows for real-time assessment and management of all stroke patients. Neurologists can see the patient, discuss their symptoms, review the physical findings, and assess images from a CT scan.
- Improved access to best practice stroke prevention and care.
- More ischemic strokes are treated with tPA, more quickly, reducing subsequent brain damage.
- More strokes are prevented as a result of increased access to secondary prevention services.
- Patients have lower acute care costs, as well as lower long-term health and social support costs.
- Use of the country’s limited number of stroke care specialists is optimized and the impact of their knowledge and experience is increased.
- Telestroke services started with a pilot project in the Eastern Health region which linked physicians in Carbonear with neurologists in St. John’s.
- Funding provided by the Canadian Stroke Network helped expand the initiative into a provincial program.
- Under the program, remote sites located in St. Anthony, Happy Valley-Goose Bay and Gander are now connected to St. John’s , improving access to timely tPA treatment.