AI-POWERED STROKE CARE SAVES LIVES: Health First’s advanced stroke care helps patients get back to active life

Two years ago, Health First implemented artificial intelligence-based software

BREVARD COUNTY, FLORIDA – Wayne Trzeciak had a pretty good idea what was happening to him that early afternoon last month. The headache suddenly struck him on the left side, and almost immediately, “the whole right side of my body froze.”

He slipped off his office chair and fell to the floor.

Trzeciak’s mother was exactly the same age as he is now when she suffered a stroke, a sudden condition in which blood fails to reach part of the brain, usually because a blood clot blocks a vessel, and sometimes because of bleeding from the vessel itself.

Trzeciak’s wife, Gail, went shopping, but soon returned home and assessed the situation clearly and quickly. She made the right decision by calling 9-1-1 rather than helping her husband into the car and making the trip herself.

“It all starts with 9-1-1,” he says.

Ambulances and a fire truck arrived within about 10 minutes. Minutes later, they found themselves in the emergency department at Viera Hospital at Health First, but paramedics were already there performing their first stroke assessment.

Investing in advances in stroke treatment

Two years ago, Health First installed Viz.ai, an AI-powered software that evaluates hospital computed tomography (CT) scans and helps locate the culprit of a stroke. The software then sends the appropriate images to the Stroke Team members’ cell phones.

Health First also recently invested in Telespecialists, a service staffed by on-call neurologists who also perform brain scans and consult with emergency room and hospital physicians to immediately begin stroke-reversing treatments such as thrombolytics.

“Telespecialists provide rapid virtual assessment of stroke patients and accelerate the new treatment decisions we need to make to achieve outcomes like Wayne’s,” says neurologist Jill Miller, MD.

In many cases, the best way to dissolve a clot and restore blood flow to the brain is thrombolytic (“clot-dissolving”) treatment. At Health First it is Tenecteplase, and Trzeciak received the bolus 28 minutes after the ambulance arrived.

“They gave me a clot-busting drug and everything came back to life,” says Trzeciak. “I feel the same as before the stroke.”

Stroke alarm reduces diagnosis and treatment time

In the event of a stroke, minutes count. When oxygenated blood is cut off from brain tissue, it dies. Health First records each stroke patient’s time from entry (the “door”) to the time the thrombolytic drug is administered (the “needle”), and the average door-to-needle time in the healthcare system is currently a remarkable 45 minutes.

“It’s a complex process that involves making the correct diagnosis – ischemic stroke – and then providing care,” Dr. Miller says.

“When a stroke alert is called, the entire team is called immediately so that care can be provided simultaneously. Stroke-trained nurses assess the patient’s condition at the bedside. The phlebotomist is there collecting blood. Radiology technicians place the patient in the scanner – the radiologist is notified to review the scan immediately, and the teleneurologist on the screen assesses everything and helps diagnose and treat it as quickly as possible.”

Back on his bike

The Trzeciaks moved to Viera twice – first about a decade ago, before leaving for work, and then they returned to retirement a few years ago. They love this place – both the current amenities and its bright future.

“The care we received at Health First was amazing,” says Wayne Trzeciak.

“A stroke can be incredibly devastating, and for us (doctors), a lot has to happen quickly,” Dr. Miller says. “It is truly rewarding to see a patient who not only received effective and appropriate care, but also achieved the best possible outcome – complete resolution of symptoms.”

Third child bikes up to 10 miles a day. Advanced stroke care at Viera Hospital, his wife’s quick actions and the quick response of Brevard Fire Rescue helped him get back on his bike without significant damage.

He has already thanked the emergency services who dealt with his case and said he would like to do the same for the hospital doctors and nurses who cared for him.

If there’s a lesson to be learned from this, go to your doctor’s appointments, says Trzeciak, and follow the most sensible medical course. This means that if you need to treat a blood marker like cholesterol with medication, don’t convince yourself that you will make enough lifestyle changes instead.
“Don’t put it off and don’t put it off until later.”

BEST

Stroke is the leading cause of long-term disability in the United States, affecting approximately 800,000 people each year. The mnemonic used at Health First to help residents spot stroke symptoms is BEFAST

■ Balance Are you or your loved one unstable?
▪ Eyes Have you lost your eyesight?
■ Face Does your smile look uneven?
n Shoulder Is one arm weak?
■ Speech Is speech slurred?
■ Time It’s time to call 9-1-1.

Don’t ignore the balance and vision symptoms B and E, says Whitney Adkins, nurse manager of Health First’s Neuroscience Program. They are associated with anterior and posterior strokes, which present in ways that are often confused with other conditions: 16% of anterior strokes and 37% of posterior strokes are initially misdiagnosed.

And call 9-1-1, don’t settle for driving your loved one to the nearest emergency room (and never drive yourself).

“This is the key to quick and coordinated care,” Dr. Miller says. “EMS is able to assess the patient’s condition at the scene and inform the nearest hospital stroke center. The patient is brought directly to the hospital CT scanner, and teleneurologists often perform the assessment literally right next to the scanner.”

To learn more about stroke and take a quiz to quickly assess your risk, visit HF.org/stroke.