Elizabeth Hanan was just sitting down to dinner on Christmas Eve last year with family at their holiday home in Arrowtown, when her two daughters noticed her face looked lopsided and her speech was slurred.
Concerned their mother may have suffered from a stroke, an ambulance was called, and Mrs Hanan was admitted to Lakes District Hospital in Frankton. She then became the hospital’s first stroke patient to receive thrombolysis treatment via telehealth technology.
Lakes District Hospital implemented the South Island’s new telestroke service early December 2019, enabling neurologists and stroke specialists in Christchurch to provide advice and support via video link to doctors treating stroke patients in smaller centres and after hours.
The 82-year-old Dunedin resident was treated by Dr Jenny James in Frankton, who performed an examination with Christchurch neurologist Dr Teddy Wu, via video link to Christchurch. Mrs Hanan received ‘clot-busting’ thrombolysis treatment and was then flown by helicopter to Invercargill Hospital, due to bad weather in Dunedin. Two days later she was sent home to the acute stroke unit at Dunedin Hospital. She has since made a full recovery, with no residual symptoms.
Dr James says the entire telehealth process went very smoothly. “Having an expert there who can see the patient and their scan with his own eyes to decide on the treatment with you really gives you confidence. It also provides families with the reassurance that their loved one is getting the best care possible. Thankfully, Elizabeth’s family brought her in straight away, so the treatment was administered to her within three hours – which research shows has the biggest benefit following a stroke.”
Dr Susan Weggery was the lead clinician setting up the telestroke pathway in Queenstown. She says after the redevelopment of the hospital’s emergency department, the addition of a CT scanner meant they could now offer thrombolysis treatment. “Up until then, the standard policy for all patients who presented with a stroke would be flown by helicopter to Dunedin Hospital, bypassing Lakes District Hospital altogether. So, for the past few years, we have been more focused on rehabilitation services for stroke, rather than acute management.”
After liaising with a wide range of specialities and services to link the telehealth service to Queenstown, Dr Weggery hired actors and ran a series of comprehensive simulations with Dr Wu in Christchurch to practise using the dedicated video conferencing and CT image technology. “The simulations were a learning experience on both sides and helped us iron out any kinks. Setting up the service was a real collaborative effort and it’s fantastic that we got the first patient through and it went as smoothly as it should have. We really appreciate all the support we’ve had to help make the service happen.”
The South Island telestroke service helps to ensure smaller communities across the South Island can access the same 24/7 neurological expertise and care as city patients. Ideally, it will also lead to more South Islanders receiving the life-saving clot retrieval procedure, which is currently available only at Christchurch Hospital.Mrs Hanan is grateful for the service and feels lucky she had such a quick recovery, without the need for any post-stroke therapy. “Once you get to my age, you really need to be close to health services. I’m extremely lucky – I feel like I dodged a bullet.”