In Montreal, ambulance paramedics redirect acute stroke patients directly to university hospital centers (CHU), such as the CHUM. In the suburbs, the process is different, stroke patients are usually transported by default to the nearest hospital. The medical team on site then assesses the severity of the patient’s condition and determines whether specialized intervention is required. If this is the case, the patient must be transported again by ambulance to a university hospital center.
This teletriage pilot project is an initiative of the CHUM’s neurovascular program. Conducted only in Montérégie for the time being, its aim is to reduce the time between a patient’s stroke and his or her treatment. Using the Microsoft Teams application, teletriage enables paramedics to make direct contact with a remote doctor who can assess the severity of the stroke. The average call takes just 5 minutes! Thanks to telehealth, the patient can be redirected as quickly as possible to the nearest regional hospital or university hospital center.
We compared patients who go through teletriage with those who follow the usual trajectory, and those who have to undergo an urgent procedure such as thrombectomy have access to it on average more than an hour earlier.
An hour earlier makes a major difference, since every minute that elapses before treatment is given increases the risk of after-effects.
Radio-Canada speaks about it
Read what Dr Christian Stapf, vascular neurologist and head of the pilot project at CHUM, and stroke victim Lucy Michaud have to say:
It’s a successful mission for this project, significantly improving stroke management! Hopefully, the CHUM experience will inspire other regions of the province to deploy this new telehealth modality.
Find out more about stroke and its treatment
There are two types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic stroke is the most common. It is caused by a clot that blocks the passage of blood to a part of the brain. Hemorrhagic stroke, on the other hand, is caused by a blood vessel bursting in the brain, causing internal bleeding. In the affected area of the brain, cells die one by one from lack of oxygen. That’s why it’s vital to act quickly.
There are two possible treatments for ischemic stroke: thrombolysis and thrombectomy. Thrombolysis is a drug injected into the patient to break up the clot within 4 hours of the stroke. Thrombectomy is a surgical procedure designed to remove the clot as soon as possible after the stroke. In more serious cases of ischemic stroke (acute and severe), thrombectomy is recommended.
Look at the Parcours Locomotive du CHUM (in French only)
page for more details on stroke and stroke rehabilitation.