Stroke “Robot” Saves Critical Minutes

October 24, 2012

by Russ Pulley | Reprinted courtesy of Lee's Summit Journal

Lee’s Summit Medical Center recently added robotic technology to its arsenal for treating stroke patients.

“Andy,” for android (the nickname hospital staff gave the device) allows a neurologist from another location to interview and observe patients first hand, saving crucial time in diagnosing strokes.

“It’s better than relying on a description from the nurse,” said Gina Gregg, who is the stroke coordinator for the hospital.

Here’s how it works:

A stroke occurs when blood flow is interrupted to the brain, either from a clot or hemorrhage. The sooner treatment starts, the less damage there is to the brain.

“Time is brain” it’s said and the emergency room staff doesn’t want to wait for a neurologist to drive to the hospital in the evenings or on weekends when one is not at the hospital.

Instead they reach the on-call neurologist who logs on to a laptop computer, using a secure wireless network, and links to robot at the medical center that’s in the patient’s room.

The doctor’s face shows up on the robot’s screen, with a smaller image in the corner where the patient can see what the doctor sees. That helps make the patient more comfortable with the communications.

The doctor controls a robotic camera, zooming in to look at the patient’s face so they can look for symptoms of stroke. They talk with the patient; the robot is equipped with speakers and microphones.

All of Lee’s Summit Medical Center’s Emergency Room, Intensive Care Unit and Progressive Care Unit nurses are trained on assisting the physician using the robot, Gregg said.

The hospital is looking at other applications for the robot, one is to use it for evaluating patients who may need psychiatric care, Gregg said.

Some units manufactured by InTouch Health, which built the hospital’s machine, are self propelled, guided by the physician using a joy stick, but Lee’s Summit Medical Center chose one that is wheeled to the room by a nurse, who can then assist the doctor and patient.

Symptoms of stroke include weakness or numbness on one side of the face or body, blurry and dimming or no vision, difficulty swallowing or talking or understanding others’ words, dizziness, falling or loss of balance, severe or unusual headache.

Kathryn Hedges, neurologist at the medical center, said reducing any delay in diagnosis is essential because minutes can make the difference in saving brain function. And there’s a 4-and-half hour window that limits administering blood-clot-busting drugs if that’s the right treatment.

Hedges said it is 20 minutes door-to-door from her home to the hospital.

“It’s faster than me driving,” she said. She is at the hospital weekdays, but otherwise she or other neurologists are on call.

Hedges said determining when the stroke happened sometimes requires detective work.

If a patient comes in with symptoms after waking in the morning, she’ll try to narrow the time by asking the patient if they’d gotten up to go to the bathroom and if they had symptoms then, and what time that was.

Hedges can also look at CT scan or MRI images made at the hospital remotely on the computer, or other lab tests, so she can determine if the stoke is from a brain hemorrhage or a clot and order appropriate care.

A nurse assisting Hedges can use a stethoscope on the robot for checking the patient, listening on headphones as the sounds are transmitted to Hedges who can hear them through her computer.

The robot also has built in handset so a doctor and nurse can speak privately if needed.

Hedges said she’d go through the exam just as if she were in the hospital room.

Asking the patient to smile, she’ll watch for any slackness of facial muscles. She notes how much muscle control the patient has by asking them to raise their arms or legs for 10 seconds and observing their movement.

On the robot screen Hedges can flash drawings or sentences to be described or read by the patient to help Hedges assess how the patient’s brain is functioning.

“I can go through a whole neurological exam, talking to the patient,” Hedges said.

Photo: (courtesy of Rull Pulley/The Journal) Kathryn Hedges, neurologist, and nurse Gina Gregg, stroke coordinator, acting as a patient, demonstrate Andy, Lee's Summit Medical Center's new stroke "robot" which allows doctors to save critical time in making an emergency diagnosis from home instead of driving to hospital.