Rapid response in stroke patients is the picture of patient safety

Posted by Karen Sonnwald on Mar 13, 2020 7:00:00 AM

Every four minutes someone dies of stroke; it ranks in the top five leading causes of death and disability in the United States. Rapid response can mean the difference between life and death, as well as whether a patient will live with disability due to stroke complications.  

But it’s not just about identifying patients who are candidates for treatment. To minimize additional risk to the patient, it’s also critical for clinicians to rule out those who will not benefit from treatment. 

“When it comes to interpreting radiology exams, patient safety really hinges on two factors – timeliness of a ‘read’ and the accuracy of the diagnosis,” said Sloan Miller, MD, CPHQ, CPPS, Medical Director at vRad.

vRad, a MEDNAX company, is a premier provider of teleradiology services and trusted partner of stroke centers nationwide. Each year, vRad radiologists, including many fellowship trained neuroradiologists, read over 130,000 stroke studies and 8,700 CT cerebral perfusion studies, with specific stroke protocols built into its system to make sure stroke scans receive urgent priority.  

What causes stroke? 

A stroke occurs when blood flow to the brain is disrupted by a clot blocking a blood vessel (an ischemic stroke) or a blood vessel rupture (a hemorrhagic stroke). In both cases, the lack of blood flow causes brain cells to die. 

For ischemic stroke, many patients who are diagnosed early can be treated with medication or a procedure called mechanical thrombectomy, used to clear the blockage and restore blood flow to the brain. The earlier the intervention, the greater the chance of success.  

Patients who have exhibited stroke symptoms for many hours and those with large strokes are or are unlikely to benefit from treatment, and experience a high rate of complications from treatment, such as bleeding in the brain. Because of the risk of additional bleeding, patients with hemorrhagic stroke are not candidates for these treatments.    

The vRad difference

A basic CT scan is the first line imaging test for patients with stroke symptoms. A CT scan can detect blood in the brain and, depending on the situation, may help assess the size and age of a stroke. A CT scan may also uncover another medical condition that is mimicking stroke symptoms.  

vRad's Stroke Protocol is designed to provide rapid radiology response for stroke patients. On average, vRad radiologists provide a report to the ordering physician within 7 minutes of receiving the scanvRad incorporates several strategies to ensure a timely, accurate diagnosis including:

  • Automatic escalation: A CT scan to assess acute stroke is given a special designation that automatically escalates it to the top of the reading list and sends an alert to every radiologist on the schedule with privileges to read for a facility. 
     
  • Scoring system: Using the ASPECTS scoring system, radiologists can determine the size of certain ischemic strokes, which can help identify candidates for treatment
     
  • Artificial Intelligence (AI) algorithms: AI algorithms can accurately recognize images that exhibit a high likelihood for specific pathologies like acute ischemia and acute bleeding in the brain, and then further prioritize those critical cases.

  


 

Topics: Patient Safety, Radiology & Teleradiology