Brijesh Mehta, M.D., a neurointerventional surgeon and Medical Director of Stroke and Neurocritical Care at Memorial Healthcare System in Fort Lauderdale, Florida, talks about a program that is saving the lives of stroke patients before they arrive at the hospital.
Interview conducted by Ivanhoe Broadcast News in August 2016.
Can you tell me a little bit about using the app or how the technology is useful for you, what big of a difference does it make for you?
Dr. Mehta: When a patient is suffering from a stroke, time is of essence. Studies show that approximately two million neurons are at risk for irreversible injury, every minute that elapses until the artery in the brain is opened up. The earlier we can know about a patient we can anticipate. We know that prehospital notification from EMS is really effective in aligning all of our multi-disciplinary teams in the hospital as quickly as possible so that when a patient arrives we can quickly do a CT of the brain, see what’s happing. Is there a bleed or confirm that there is indeed a blockage of a large artery in the brain and mobilize our Cath lab teams and so forth. If the EMS calls us while they’re in route then we can mobilize our Cath lab team as quickly as possible so that by the time the CT scan of the brain is done our team in the lab is ready to quickly treat that patient. Up to now we didn’t really have an effective mechanism to receive these notifications from EMS. Thankfully as smart phones have evolved and the technology has become more adopted there are now mobile applications available that allow us to receive these notifications as a push alert on the smart phone for all the disciplinary team members, so that it avoids the redundant phone calls that all the parties have to make in order to prepare for the patient. One notification goes to all the neurologists, the neuro interventionist, the Cath lab staff so that we’re all on the same page and when the patient arrives we’re all ready. That has really helped us reduce our time to treatment. From upwards of a hundred and thirty minutes before to now because of the parallel process in the hospital, everybody being mobilized at the same time via the EMS alert. Ideally through these innovative apps down to about sixty five minutes.
Can you give me some specifics about the apps, is there more than one that you’re using?
Dr. Mehta: Yeah, there are several apps that are being tested on the market right now. They all came around sort of one after another. Their startup versus the Pulsara app, which allow you to receive the EMS stroke alerts as well as alerts for STEMI like heart attack patients as well as trauma and sepsis. There’s an app called Join which also in addition to stroke alerts it incorporates the imaging that is performed on arrival. The emergent brain imaging and allows you to share those findings among the teams so that it’s not using cumbersome multiple interfaces, it’s all within one streamlined app. There are others that are coming on board in the near future that actually allow you to track a patient’s progress real time without manually entering any information. Those are apps that we’ll be studying and hopefully adopting if we find that they reduce the amount of data entry that’s done manually and focus on the patient.
Anything else you want to add?
Dr. Mehta: I would say that right now is a really a watershed moment for the stroke field because we’ve had multiple randomized control trials that have been effective proving the therapies that we perform in the Cath lab to retrieve these clots. That treatment is called mechanical thrombectomy. The timing could not be more perfect for us to work closely with EMS to streamline our system of care and adopt these innovative technologies to deliver the best outcomes possible for our patients.
END OF INTERVIEW
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