Time saved is brain saved

“Time saved is brain saved,” said Sharon McGowan, Stroke Foundation CEO, who supports the Victorian Stroke Telemedicine (VST) Program and welcomes the $7.5 million, four-year commitment by the Victorian Government towards the Stroke Ambulance trial. These two initiatives are designed to provide rapid access to the time-critical diagnostics and medical treatment required to improve the outcome for stroke patients.

A new stroke occurs in Australia every 10 minutes — almost one thousand new strokes each week. Stroke is one of the leading causes of death and disability in Australia, and is estimated to cost the economy over $5 billion each year.

When someone suffers a stroke, every minute counts. The sooner treatment is provided, the better the chance of a good recovery.

The Victorian Stroke Telemedicine (VST) Program is providing, for the first time, ready access to stroke specialists for people living in rural and regional areas who present to local emergency departments. These specialists are able to consult with local clinicians and the patients using video technology and decide whether effective world-class stroke therapies, such as thrombolysis drugs and endovascular clot retrieval, could be used.

Rapid access to specialists and making treatment decisions quickly are important because ‘Time is Brain’ and therapies must be given as close to the onset of the stroke symptoms as possible to achieve a good outcome.

The Victorian Stroke Telemedicine (VST) Program

The VST Program is unique in Australia and facilitates rapid clinical decision-making and treatment of stroke by seamlessly connecting rural and regional emergency departments to a roster of Melbourne-based neurologists. The neurologists are accessible every day, all day (24/7/365) via a single 1300 telephone number. Through new ‘state-of-the-art’ mobile computing technology and software, the neurologist can remotely examine patients at the bedside, review brain imaging and provide rapid diagnosis and treatment advice, irrespective of their geographic location.

The aims of the VST program are to:

• increase equity of stroke care in rural and regional hospitals;
• reduce delays in diagnosis and treatment; and
• improve access to stroke thrombolysis and endovascular clot retrieval, which are proven to lead to better patient outcomes.

To date, over 1200 patients in regional Victoria have been treated by VST, with many successfully transferred into The Royal Melbourne Hospital for endovascular clot retrieval.

The VST program is based at the Florey Institute of Neuroscience and Mental Health and is led by Prof Chris Bladin and A/Prof Dominique Cadilhac. VST first commenced in 2010 and over the years has received funding from the Commonwealth Department of Health – Health and Hospitals Fund, the Victorian Department of Health (Victorian Stroke Clinical Network), Monash University, amongst others.

Deployed through the VST program is new, fully integrated telemedicine technology, designed for healthcare in the emergency departments of the 16 participating hospitals in regional Victoria. Importantly, there is extensive data collection to monitor clinical and patient outcomes. This data collection is facilitated by the use of the Australian Stroke Clinical Registry (AuSCR), and a full clinical and health economic evaluation of VST program is being undertaken.

Mobile Stroke Unit trial — Stroke Ambulance

Australia’s first ever dedicated stroke ambulance, or mobile stroke unit (MSU), will hit Melbourne streets this year to provide the quickest possible diagnosis and treatment for patients suffering a life-threatening stroke.

Director of the Melbourne Brain Centre at The Royal Melbourne Hospital, Professor Stephen Davis, said Australia’s first mobile stroke unit (MSU) was all about bringing the stroke unit to the patient.

“Incorporating a CT brain scanner in the ambulance allows brain imaging and diagnosis at the patient’s home, and facilitates the potential use of urgent therapies, such as clot-dissolving treatment of stroke. This will allow many more patients to be treated in the golden hour after stroke onset, giving our patients the best chance of a good recovery,” Professor Davis said.

With a CT scanner on board and a dedicated MSU team comprising a stroke nurse, radiographer, stroke neurologist and Ambulance Victoria paramedics, diagnosis and interventions, such as clot-busting thrombolysis, can begin immediately in the field rather than waiting until the patient has arrived at hospital.

Thanks to leading Melbourne business donors, the Victorian Government, the Stroke Foundation, Ambulance Victoria, The Royal Melbourne Hospital and The Florey Institute, the vision of having a mobile stroke unit will soon be a reality.

Image caption: Stroke ambulance (artist’s impression), supplied by Stroke Foundation.