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TeleStroke Program Connects Patients with Stroke Experts, Improves Recovery

Telemedicine, which utilizes electronic communication between healthcare providers and patients-think online video chat apps like Skype or Facetime, is transforming the way healthcare is delivered. In many cases, it enables care for patients who may not otherwise have access.

At Penn State Health St. Joseph, telemedicine has transformed treatment for suspected stroke patients, giving them access to Penn State Hershey stroke specialists at any time of the day or night.

Long recognized for its Stroke Center, St. Joseph was the first emergency department to partner with Penn State Hershey in its TeleStroke via LionNet program, an innovative and cutting-edge method of treating stroke patients in St. Joseph’s emergency department.

According to Rebecca Hackney, clinical coordinator of operations and quality at Penn State Health St. Joseph, the TeleStroke program is a game changer.

“Utilizing TeleStroke via LionNet enables us to get a Penn State Hershey stroke specialist to a patient’s bed side remotely,” Hackney explained. “The specialist can see and assess the patient, and determine what types of treatment should be employed. All this can happen very quickly, which is vitally important in the case of a stroke patient.”

When a suspected stroke patient enters St. Joseph’s emergency department, time is of the essence. That’s because medication used to reverse stroke symptoms can only be administered within three hours of the onset of those symptoms, and endovascular treatment must occur within 12 hours of onset.

The very first procedure once the patient enters the department is to secure a CT scan. That’s to determine whether there has been bleeding to the brain, Hackney explained. If bleeding has occurred, certain medications cannot be administered.

The patient is then placed in a room in the middle of the emergency department, where he or she can be closely monitored and attended.

“We put stroke care patients front and center in the emergency department,” Hackney said.

Routine procedures and screenings are performed, and the patient’s medical history is evaluated.

Meanwhile, a member of the healthcare team is charged with contacting a designated Hershey stroke specialist by phone and initiating a TeleStroke consultation.

The specialist on duty accesses the TeleStroke program on his or her laptop and is ready to consult with the patient and St. Joseph healthcare providers within 15 minutes of the call.

“We’ve seen physicians complete consults in their cars on the side of the road,” Hackney said. “It’s amazing how efficient this program is.”

Using the program, the physician can do a complete neurological exam and observe the interactions between the patient and his or her nurse.

Based on the exam and observations, the specialist usually can recommend what treatments are appropriate – or not appropriate – for that particular patient.

Treatment can start immediately, ensuring the best possible outcomes for the patient.

“Being able to get that provider to the patient so quickly is a huge advantage,” Hackney said.

Formerly, a patient who suffered a severe stroke may have needed to be transferred to Penn State Hershey Medical Center for specialized care. The need for transfer is greatly reduced through the use of the TeleStroke program.

“Most patients now can stay at St. Joe’s,” Hackney said. “And, that’s really important for them and their families.”

The Stroke Center at Penn State Health St. Joseph is a Certified Primary Stroke Center, fully equipped and committed to caring for the needs of a patient during a stroke emergency. Its partnership with Penn State Hershey has further enhanced care available to patients, Hackney said.

Penn State Health St. Josephs Emergency Department is a Certified Primary Stroke Center that provides full emergency services, 24 hours a day, seven days a week. Stroke is a medical emergency, if you or loved one experiences any signs of stroke, immediately dial 9-1-1 and do not attempt to drive to the hospital.

Supporting the Mind After a Stroke

Victoria Rottler, Penn State Berks student

The house is silent and the bedroom is pitch-black except for the moon peaking in between the drawn curtains. It was just like any other typical night of rest, or so Raymond Ernst thought. In the middle of the night he decided to sit up and realized that he did not have the strength in his legs to lift them and get out of bed. Even though he thought this seemed very peculiar he decided to go back to sleep. It wasn’t until the next morning at the breakfast table, where he experienced another episode along with confusion this time, that’s when Raymond’s wife called 911 in a panic. Even though he was unaware of what was happening to him, she could tell something was very medically wrong with her husband.

“My body felt heavy and I did not have the strength to get up. All of the sudden I was in the ambulance”, explained Raymond, still not sure exactly what had happened.

After he was rushed to the hospital, Raymond was hooked up to all kinds of machines. It wasn’t until after the doctors administered a CAT scan of his brain activity, when Raymond and his wife were informed of the shocking news that he had suffered a stroke.

It is very common that the victims of strokes have no idea that their brain may be undergoing changes such as a blockage or a bleed that can lead to two different kinds of strokes. For many people a stroke starts out as a bad headache and most people don’t think twice about it. They are signs ignored at their own peril. The warning signs and symptoms for stroke include numbness of the left side of the body, vision loss, facial paralysis, and the inability to verbalize his thoughts.

“Every stroke is different, and I think it is very important for people to be informed about the warning signs”, Raymond says with hope in his voice.

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The compassionate team at Penn State Health St. Joseph agrees with Raymond’s observation. The Clinical Program Coordinator of Heart Failure, Chest Pain, and Stroke, Kristin Miller, holds a stroke support group which meets the second Tuesday of every month at Penn State Health St. Joseph, which is reaccredited by the Joint Commission as a Primary Stroke Center in Bern Township. “Our main goal is to educate the community about strokes and also to give victims a comforting atmosphere to share their stories” says Kristin with a kindhearted tone. She enjoys teaching others the FAST facts for stroke awareness. This includes emphasizing that when it comes to stroke, every second counts towards improving chances for recovery. Spotting a stoke can be done through the FAST method: face drooping, arm weakness, speech difficulty, and time to call 9-1-1.

The Support Group is open to anyone in the community and newcomers are always welcome. Raymond, along with his sister and her spouse attend the support group every month.

“It has been a great way for him to stay in touch with his family and keep them up to date on his life through-out his recovery” explains Kristin.

Besides the opportunity to share and connect with others, the stroke support group also features an expert guest speaker every month who discuss topics such as healthy diet, exercise, anti-coagulant medications, physical and emotional changes after a stroke and much more.

Twelve years later Raymond says he feels great. Besides the fact that the left side of his body still experiences numbness and he has to be careful when picking things up with his left hand, he has come a long way since the day he had a stroke.

“My brother and sister are my biggest supporters,” Raymond added gratefully.

Surviving through a stroke is blessing all on its own. The road to recovery can be scary and overwhelming, but survivors and their loved ones that join Penn State Health St. Joseph stroke support group are never alone.

Kristin Miller, BSN, RN is the Clinical Program Coordinator of Heart Failure, Chest Pain, and Stroke at Penn State Health St. Joseph. She is responsible for the monthly Stroke Support Group and conducts community education surrounding FAST facts for stroke awareness. Kristin can be reached at KMiller39@PennStateHealth.psu.edu or 610-378-2492

Penn State Stroke Center Again Earns Highest Level of Stroke Center Designation

The Penn State Stroke Center has once again earned a designation that recognizes the high level of care it provides to patients with the most severe and challenging types of strokes.

The Center has been re-certified as a Comprehensive Stroke Center by the Joint Commission and the American Heart Association/American Stroke Association.

Penn State Health Milton S. Hershey Medical Center is the only Comprehensive Stroke Center in central Pennsylvania. Seven hospitals statewide and 100 in the United States have earned the designation.

“This designation as a Comprehensive Stroke Center reassures the people of central Pennsylvania that the resources and expertise to treat the most difficult stroke cases will be ready and waiting when needed,” said Dr. Kevin Cockroft, co-director, Penn State Stroke Center.

Penn State Health St. Joseph has direct access to the Stroke Center through LionNet, a telemedicine program which provides real-time remote audio-visual access to a neurological consult with a stroke neurologist or neurosurgeon.

At Penn State Health St. Joseph, when a suspected stroke patient arrives in the emergency department (ED), the ED provider calls LionNet and is connected with a stroke expert. Using a sophisticated computer system and a webcam, the physicians provide consultation, examine the patient, review scans, and speak to the patient and family in real-time. A treatment recommendation is made and the St. Joseph ED physician determines the best course of action. The benefits to the patient include faster treatment which can reduce brain damage and improve recovery time, and often times treatment can be provided locally reducing the need for a patient to travel.