A national first: rural stroke trial cuts time to treatment

  • Garry Tierney and Kim Cooper SCA NSW 2023
    Kim Cooper and Garry Tierney. Inset: Professor Mark Parsons.

Garry Tierney's life-threatening stroke incident near Nowra, NSW, turned into a pioneering medical response thanks to a cutting-edge clinical study by the Australian Stroke Alliance in collaboration with NSW Ambulance. The 70-year-old's treatment began with paramedics on the scene using an innovative prehospital telestroke tool.

While Garry's partner, Kim, grappled with the prospect of loss, paramedics acted swiftly. Utilizing the Zeus app, they communicated Garry's condition to neurologist Professor Mark Parsons, who, despite exercising at home in Sydney, made the decisive call to redirect the ambulance to a specialized stroke center capable of performing endovascular clot removal around the clock.

The severity of Garry's condition, indicated by a stroke score of 14, was critical, and traditional care routes were bypassed for immediate specialized intervention. Neurology advanced trainee Dr. Lucinda Tran, briefed by Prof Parsons, awaited Garry's arrival, ready with telestroke data at her fingertips.

Upon reaching Liverpool Hospital, a rapid CT scan revealed a small vessel occlusion in Garry's brain. While endovascular clot retrieval wasn't viable, swift administration of intravenous clot-dissolving medication followed. A record-breaking 31 minutes from arrival to treatment ensued, and Garry's condition improved almost instantly.

This swift response is a testament to the Australian Stroke Alliance's mission to deliver prompt and proper care. Without the prehospital telestroke technology enabling real-time collaboration between doctors and paramedics, patients could face delays that hinder their recovery.

Prof Parsons highlights the difference these advances make, with a weekly bypass to Liverpool Hospital saving a minimum of one to two hours for stroke treatment. The positive patient outcomes have been so striking that the initiative has enabled inclusion in clinical trials due to the accelerated arrival times.

Feedback from paramedics reflects the value they find in the direct interaction with the hospital team, facilitated by telehealth-enabled ambulances. The technology fosters confidence, with telestroke reports taking only minutes instead of the hour required for traditional telestroke consultations.

With pilot studies underway in New South Wales and Victoria and expansion plans in motion, the project is set to transform stroke care nationwide. The NSW team is eager to share its findings in 2024. Following Garry's episode, record times have continued to improve, with a new 24-minute benchmark set, underscoring the importance of the Alliance's telestroke platform.

For participation inquiries, visit the Australian Stroke Alliance website.

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