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TeleStroke program brings stroke specialists to the patient’s bedside

Lindy Turley, R.N.

The Emergency Department (ED) doors at Flagstaff Medical Center whoosh open as a middle-aged couple hurries inside. One side of the man’s face droops and his slurred words try to quiet his wife’s worst fears. The triage nurse, trained to recognize stroke symptoms, immediately calls a stroke alert and assists the couple to an exam room. That alert sets in motion FMC’s TeleStroke program, a carefully choreographed plan of care that connects FMC’s Emergency Department physicians and staff with the Mayo Clinic in Scottsdale via a telemedicine link.

Within minutes of arriving at the ED, the patient is assessed by an ED physician and receives a CT scan to determine whether he is having a stroke, and if so, what is causing the stroke – a blood clot or bleeding in the brain. The CT results are sent electronically to the physicians in the ED and to the neurologist at the Mayo Clinic.

The patient is then re-assessed by one of the ED physicians and the neurologist at the Mayo Clinic. The TeleStroke unit – a high-definition large-screen computer monitor with a mobile camera – is rolled next to the patient’s bed allowing Mayo’s neurologist to become an active member of the healthcare team through the unit’s real-time two-way video conferencing.

Working with the physicians in the ED, the neurologist uses the camera and monitor to perform a thorough neurological assessment of the patient, as well as interact with family members, physicians and nurses. Most importantly, the neurologist helps determine if the patient is a candidate for t-PA, the clot-busting drug that improves recovery in strokes caused by blocked vessels. This drug must be administered within several hours of the onset of the stroke to be effective.

The collaboration between FMC and the Mayo Clinic is part of Stroke Telemedicine for Arizona Rural Residents (STARR), a statewide effort to ensure stroke victims have immediate access to an assessment by a board-certified neurologist who specializes in stroke care. Current data shows only 55-percent of Americans live within an hour’s drive of an acute-care stroke facility that can provide this intervention. In rural Northern and Central Arizona this number may be even greater. That is why FMC collaborated with Mayo Clinic in Scottsdale, the hub and principal hospital in the STARR program.

Time is Brain – act F.A.S.T.
When stroke happens, time is brain. Stroke is the third-leading cause of death and foremost cause of disability. When brain cells die during a stroke, abilities like speech, movement and memory can be lost. Getting a proper diagnosis and rapid treatment improves a patient’s outcome dramatically. Every minute counts to preserve optimum brain function.

Use the F.A.S.T. method for recognizing and responding to stroke symptoms:

F = FACE When smiling, does one side of the face droop?
A = ARMS When raising both arms, does one arm drift downward?
S = SPEECH Does the speech sound slurred or strange?
T = TIME If you observe any of these signs, it’s time to call 911.

Lindy Turley, R.N., B.S.N., C.E.N., is FMC’s director of Emergency Services. For more information about FMC’s Telestroke program, visit Is there a health topic you’d like to know more about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N. Beaver St., Flagstaff, AZ 86001, or visit