Sequoyah Memorial Hospital in Sallisaw is the first hospital in eastern Oklahoma to use telemedicine for stroke treatment in the emergency room, and one patient is happy to be alive because of the service.

July 15 started as a normal day for Leslie “Jinx” Blades. A trip to town to run errands was all she and her husband had planned for the day.

After getting up and dressing, she took her daily baby aspirin. Just before leaving the house, she began to feel something that wasn’t normal. She noticed her left leg began to feel tingly, and quickly progressed into being completely numb and limp. She also noticed a strange tingling in her left arm. Quickly she called for her husband, Jim, who gave her another baby aspirin. However, it wasn’t too long after this that she knew something was seriously wrong. She was having a stroke.

Jinx Blades was an individual who educated herself. She had read articles on stroke symptoms and what symptoms to watch in case of a stroke. While getting to the nearest hospital should be a person’s first priority, there are several symptoms of stroke of which one should be aware. According to the American Stroke Association, a person may feel weakness, clumsiness, or heaviness in the face or the limbs.

Language disturbance is also a symptom of stroke. A person may have trouble selecting words, have incomprehensible speech, trouble writing or reading, and slurred speech. Visual loss in one eye may also occur or a person may see two images instead of one. Finally, poor balance, stumbling gait, staggering, or un-coordination of one side of the body may occur.

Several risk factors can affect a person’s likelihood of having a stroke. High blood pressure, cigarette smoking, heart disease, and diabetes all increase chances for a stroke.

Jinx Blades quickly recognized the signs of stroke and was conscious enough to tell her husband that she knew something was seriously wrong. He rushed her to the nearest hospital, Sequoyah Memorial Hospital (SMH) in Sallisaw.

“My first thought was to come here,” Jim Blades said during an interview with Holly Dickson, Sequoyah Memorial Hospital director of public relations. “We both knew she had a certain amount of time before the stroke completely debilitated her, and she needed to get to the nearest emergency room.”

The amount of time Jim Blades is referring to is known as the window of three hours from when a patient first begins experiencing stroke symptoms to when the clot-buster drug, known as TPA, can be administered. A stroke patient can lose up to 32,000 brain cells per second while having a stroke. The drug can only be administered after the patient is evaluated by a neurologist who verifies that the patient is experiencing a stroke and therefore a candidate for the drug.

At the Sequoyah Memorial Hospital emergency room, Jinx Blades was evaluated to determine the cause of her condition. By this time, she describes her leg as feeling “like spaghetti” and the tingling in her left arm had not subsided. After several tests, the stroke team of nurses, radiology technicians, laboratory technicians, pharmacy technicians, IT, clerical staff, and the physician, decided it was time to bring out the telemedicine equipment and connect Jinx Blades with Margaret Tremwel, MD, PhD, a neurologist with Sparks Health Systems in Fort Smith, Ark. Sequoyah Memorial Hospital has partnered Sparks Health Systems to evaluate stroke patients.

Within eight minutes, Jinx Blades was connected via an Internet connection over a television monitor to Dr. Tremwel who began to evaluate her condition along with the stroke team.

“They wheeled in the monitor and explained everything,” Jim Blades said. “They got the tech in, called the neurologist (Tremwel), and began the exam. It was really cool that she could see us and we could see her in the monitor! The entire staff was monitoring the time because they knew her three-hour window was closing. It was like a fire drill — everyone was in their place and doing their job, and they worked so quickly and so well. The nurses and doctor were so professional.”

After undergoing the standard neurological exam via telemedicine monitor, Dr. Tremwel determined that Jinx Blades was a candidate for the clot-buster drug. After it was administered, Jinx Blades was soon able to lift and move her left leg, the same leg she could not move or feel when she presented to the emergency room.

Sharon Randolph, RN, CNO for Sequoyah Memorial Hospital, was ecstatic.

“She could move her leg, and could feel her leg,” she said, glowing from head to toe after working with Mrs. Blades. “It was the most amazing thing!”

Sequoyah Memorial Hospital first began the process of obtaining telemedicine services last summer.

Gone are the days when patients in rural communities have to drive to the nearest big city to consult a medical specialist or get advanced medical advice critical to their health. Telemedicine is one of the fastest-growing medical technologies. The equipment obtained by Sequoyah Memorial will be used not only for stroke intervention and treatment, but also for other specialties and will provide critical medical support and access to specialists in urban areas. It has become the most important use of compressed video technology.

In addition, telemedicine has become a critical part of programs for staff training. Telemedicine allows a live connection to specialists who are not on site but may be in major medical centers in other cities.

Debbie Knoke, the hospital’s administrator, said that, “Many times the specialty services are needed for consultation in the treatment of patients at SMH.”

The first project for telemedicine utilization for Sequoyah Memorial was the stroke treatment program in conjunction with Dr. Tremwel, a neurologist affiliated with Sparks, and one of Arkansas’ leading vascular neurological physicians. Prior to Sequoyah Memorial launching the telemedicine program, Dr. Tremwel conducted training with SMH staff. According to Knoke, at present, all nursing staff are certified in American Heart NIH Stroke Certification. A stroke team was identified and is made up of physicians, nurses, pharmacy technicians, and radiology technologists.

“Sequoyah Memorial is excited to continue to improve efficiency, optimize quality and safety, and improve patient care,” Knoke said. “This new service aligns directly with the mission of SMH in providing local access for services that enhance the individual health and well being of our patients.

“The scope of rural healthcare should not be underestimated,” Knoke said. “According to the Oklahoma Hospital Association, of the 124 hospitals in the state of Oklahoma, we are among the first to utilize telemedicine for stroke treatment in the emergency department. This is a crowning moment for our staff, patients, and community. Our stroke team has been working diligently with Dr. Tremwel and Sparks Regional Medical Center since last year to bring this service to our community.”

Sequoyah Memorial has endless potential with the skilled staff and the capabilities of telemedicine. The patient is Sequoyah Memorial’s main focus and also drives the hospital’s commitment to excellence.

The telemedicine service would not be possible without the Sequoyah Memorial Hospital Ladies’ Auxiliary group. Their dedication to this cause was instrumental. Their donation of $15,000 following the spring fundraiser was paramount to Sequoyah Memorial securing the needed equipment to implement telemedicine.

The support of Oklahoma State University Center for Health Sciences Telemedicine program, through their donation of the telemedicine cart, was also very significant; their dedication to the health of rural Oklahoma is very evident through their mission, which is to provide specialty physicians and services to rural Oklahomans through Telemedicine.

Knoke said, “Sequoyah Memorial is very aware that our region ranks number one in the nation for the incidence of stroke among residents because the area is lumped into the Fort Smith metropolitan area. Arkansas ranks number one in the nation for stroke. It was this knowledge that drove Sequoyah Memorial to break into the field of telemedicine to provide residents with immediate access to life-saving healthcare.

“We are also very thankful to Dr. Tremwel and Sparks Health System for raising awareness about stroke in our region,” said Knoke. “Their involvement is vital to ensuring the health of all area residents.”

The Blades couldn’t be happier with the results. The good news doesn’t stop there, either. After being admitted to the ICU at Sparks, Jinx Blades was discharged two days later. She was referred for physical therapy, but after walking in and being evaluated by the therapist, it was determined that she needed no physical therapy after her ordeal. She returned to work the following Monday, walking up the 20 steps to her office.

The Blades thanked everyone who was part of the team that day.

“Everybody did a really good job,” she said. “The way the staff organized things was amazing. They kept a watch on the time and everything ran smoothly.”

Jim Blades said, “I just want to say thank you. We are ecstatic. I would also like to tell people that if they do have a life-threatening condition like a stroke, to go to Sequoyah Memorial first.”