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A stroke is when there is a sudden disruption of the blood flow to a part of the brain. The cause may be the blockage of a blood vessel in the head, leading to a brain thrombosis. A blood vessel may also rupture. In that case, there is a hemorrhagic stroke. However, most strokes – some 80% of them – involve thrombosis. What matters then is to dissolve the blockage in the blood vessel as quickly as possible. This is generally done by giving anticoagulants. “There are two crucial elements: time and competency,” explains Dr Raf Brouns of the Department of Neurology at the UZ Brussels. “Every second counts and acting quickly can make the difference between life and death, or between recovery and lasting disability.” Due to the time-sensitive nature of stroke treatment, the competency is also extremely important. An experienced team can take the right decisions faster, which leads to better results.
The quest to save time
This insight is the basis for a project organized by the stroke unit at the UZ Brussels. If a patient believed to have had a stroke arrives at the emergency room, someone at the hospital presses a red button, so to speak, so that the entire team can immediately spring into action. “We looked at stroke treatment as a process and developed a solution to further optimize it,” recounts Dr Brouns. “Initiating treatment during the transport of the patient is the next step.”
The aim of the research project is to save time. “This increases the patient’s chance of recovery,” notes Alexis Valenzuela Espinoza, project coordinator at the UZ Brussels. “At the same time, we also wanted to get the necessary expertise to the patient more rapidly, by bringing the doctor onboard the ambulance, virtually.”
The stroke unit at the UZ Brussels developed an application to meet this need. In simple terms, it could be described as an advanced form of mobile videoconferencing. “Inside the ambulance, there is a modern telemedicine system,” Espinoza continues. “The doctor logs in over the Internet and can immediately communicate with the patient and the medical staff in the ambulance.” Simultaneously, the system provides information about the patient to the doctor, such as identity, blood pressure, blood sugar and blood oxygen level. The system allows the doctor to assess the severity of the stroke, even before the patient arrives at the hospital.
In order to be able to use the application successfully in a speeding ambulance, there was a need for a mobile connection with high availability and considerable bandwidth. The 4G network from Belgacom makes this possible. In fact, the project at the UZ Brussels functioned as a test case for the rollout of 4G in the Brussels region. “Stroke patients can usually expect a long recovery period,” points out Dr Brouns. “The faster the patient receives the right treatment, the smaller the chance of permanent disability or dementia. In this sense, our solution also helps to reduce the costs to society caused by strokes.” After evaluation of the ongoing pilot study, the project may be reproduced in other fields. Theoretically, the concept could be applied in a wide range of interventions where time is of the essence.
The Universitair Ziekenhuis Brussel is the teaching hospital of the Vrije Universiteit Brussel, performing an educational role as well as organizing scientific research. There are 3,400 employees associated with the UZ Brussels. The hospital has 721 beds and counts some 1,500 consultations every day.
Bi-directional audio and video communication between a specialised doctor, the emergency medical team and the patient in the ambulance, via the Belgacom 4G network:
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