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STRokE DOC Puts Experts at the Scene

One out of every three US residents lives in a rural area that makes getting immediate medical care in times of emergency a sometimes-risky predicament.  Speed of emergency medical care is especially important with medical emergencies such as stroke, a situation that benefits most from the earliest treatment.

At the University of California’s (UC’s) Medical Center in San Diego, doctors, emergency services personnel, and research scientists have teamed up to test a new technology that allows emergency responders to get immediate, face-to-face communications with stroke experts in order to begin treatment within minutes of arrival at a patient’s location.

The chance to reduce damage caused by the stroke occurs during only a small window of opportunity and it is believed that many stroke patients would have more favorable outcomes if medical intervention could have begun earlier.  In some forms of stroke, the window of opportunity to administer stroke-stopping medications is only three hours.  The research team would like to see the system available to emergency medical responders around the world.

STRokE DOC, the more user-friendly nickname of the Stroke Team Remote Evaluation using a Digital Observation Camera system, a telemedicine system that incorporates audio, internet, and video technologies that allow an emergency responder in the field to begin immediate consultation with a stroke specialist.  The technology becomes particularly valuable in rural settings and in other areas where a dedicated team of stroke specialists may not be readily available.

In addition to relaying purely medical data, STRokE DOC allows people at both ends of the telecommunication to speak freely, allowing physicians to learn more about the patient’s health by means otherwise not available.  With STRokE DOC, doctors can ask questions of the patient and patient’s family and the patient and family can ask questions of the specialists.   Specialists can have immediate access to a patient’s CT scanned images, too, allowing for more precise diagnosis and treatment options.

To put STRokE DOC to the test, the UC research team planned a study involving 400 patients treated over a four-year time period.  STRokE DOC was used in the field, where treatment began on the spot, with diagnosis and treatment confirmation coming once the patient had been seen by hospital personnel.  A control team of emergency responders using traditional telephone-limited consultations on the scene served as the control group for comparative analysis of the telemedicine system.

After just 222 patient cases were evaluated, the overwhelming success rate of the STRokE DOC led the research team, led by Brett C. Meyer, MD, to discontinue the study.  They’ve published the full details of their study in the August 2 online edition of the Lancet Neurology.  It will be available in print form in the near future.

The STRokE DOC study was funded by Calit2, the Department of Veterans Affairs’ Research Division, and the National Institute of Neurological Disorders and Stroke.

Source: University of California - San Diego

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