Video support in stroke care: Enhancing early diagnosis

A recent study, part of the VIPHS (Video Support in the PreHospital Stroke Chain) project, shows that equipping ambulances with video streaming capabilities can allow stroke specialists to assess patients remotely and in real-time, helping determine the most appropriate care pathway. This approach is particularly beneficial for patients living in remote areas, improving access to specialized stroke care. 

Most strokes are caused by clots in the brain's blood vessels. While smaller clots can be treated with clot-dissolving drugs (thrombolytics) at local emergency hospitals, larger clots require surgical intervention through thrombectomy, which is available only at specialist centers like university hospitals. Identifying which treatment is needed early on can save valuable time. 

"A decision in the ambulance to transport a patient directly to Sahlgrenska University Hospital is estimated to save one and a half hours in processing time for patients who live outside Greater Gothenburg. This can be a life-changing timesaving for those who need a thrombectomy, as an hour's delay is estimated to halve the effect of the treatment. Every year, a significant number of people could have a completely different life if they had a thrombectomy faster," states Bengt Arne Sjöqvist, Professor Emeritus of digital health at Chalmers.  

To enhance stroke diagnosis, video cameras in ambulances allow specialists to conduct neurological assessments similar to those performed in hospital settings. This support improves the existing care process, which currently relies on telephone communication between ambulance personnel and specialist doctors. The system involves a team-based approach, utilizing real-time video to assess patients' facial expressions, limb movements, and neurological function to guide treatment decisions effectively. 

The study's feasibility was tested through full-scale simulations involving ambulance teams responding to mock stroke alerts. Neurologists played the role of patients, and ambulances were equipped with three cameras: one focused on the patient’s face for assessing head and eye movements, another aimed at the torso to observe arm mobility, and a third capturing leg movements.  

Following successful simulations, a clinical pilot study was conducted in the Södra Älvsborg region, involving real stroke patients and equipped ambulances. The pilot's success led to its implementation in Region Västra Götaland, with a focus on integrating this technology into standard healthcare practices. Ongoing efforts aim to expand the technology's use, helping stroke patients in different regions access faster and more effective care through telemedicine. 

MEDICA-tradefair.com; Source: The Swedish Research Council