Teleclinics in Kerala for stroke victims

Centres to come up in five government hospitals

The Health Department is in the process of setting up telestroke clinics in major government hospitals in 10 districts, where physicians will be trained to recognise and stabilise stroke patients.

The National Health Mission has signed a Memorandum of Understanding with the telestroke unit at Amrita Institute of Medical Sciences (AIMS) in Kochi so that physicians in select government hospitals can link up to AIMS using telemedicine facility and consult neurologists on managing specific stroke cases.

Physicians may relay CT/MRI scan images over the telemedicine link and get the opinion of neurologists, so that the patient can be stabilised at the hospital or referred to a higher centre if required.

Telestroke facilities are being set up in hospitals which have CT scan facility and telemedicine units. Five hospitals have been identified — General Hospitals in Thiruvananthapuram and Ernakulam and district hospitals in Kannur, Palakkad, and Mananthavady. Five more hospitals will be identified and telemedicine units set up to aid stroke consultation.

“MoUs for telestroke consultation with the government medical colleges in Thiruvananthapuram and Kozhikode have also been proposed. The agreement has to be formal because the patient will be managed on the basis of expert advice from the neurology departments of these tertiary-care hospitals, which will go into case records,” a health official said.

There is an acute shortage of cardiology and neurology specialists in the Health Service and this is one way in which the physicians can provide timely care to stroke patients.

Already, 70 physicians have been given trained by the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, in identifying both thrombotic and haemorrhagic strokes, using MRI/CT films of actual cases. Skills have been imparted in stabilising a stroke patient and in identifying and referring cases which may need immediate and acute care.

The time factor

Only around 10-15 per cent of those who suffer stroke reach stroke centres within the three- or four-hour window, when the brain deficit can be minimised. Beyond this time window, patients end up with life-long full or partial disability.

“Stroke rehabilitation is an essential part of stroke management. In the next phase, we will set up stroke rehabilitation units in district hospitals,” an official said.