NARH Teams with Mass. General Hospital for Stroke Services

By Susan BushPrint Story | Email Story
Video monitors, laptop computers, and remote control cameras are the tools of a NARH/Mass. General Hospital telemedicine link.
North Adams – For those stricken with an ischemic stroke, the magic number is three; intravenous administration of tPA, a blood-clot busting drug, must occur within three hours after the stroke commences and a timely, accurate diagnosis is critical to the proper use of the drug. When given appropriately, tPA can reduce the effects of an ischemic stroke and decrease permanent stroke-related disability. Real Time, Real Benefits, Real Lives Time-saving diagnostic responses are now available at the North Adams Regional Hospital, courtesy of a new telemedicine system that connects Emergency Department physicians and nurses with neurologists at the Massachusetts General Hospital. The communication between hospitals is in real time, and so far, the result has been positive. In May, two patients were evaluated and treated based on the video-audio conferencing capability. On June 9, a live technology demonstration occurred at NARH, and media members were able to observe the system in action. Dr. Lee Schwamm, director of acute stroke services at the Massachusetts General Hospital and NARH Director of Emergency Medicine Dr. Paul Donovan enlisted a volunteer “patient” to simulate a consultation. From his post in Boston, Schwamm was able to see and speak with Donovan, the patient, and others in the room. In an actual stroke situation, a MGH doctor would be able to speak with any family members present, which can aid with the patient evaluation. Communication with a MGH neurologist is possible at all hours, every day. During the demonstration, Donovan provided Schwamm with pertinent information including the patient age and symptoms. Schwamm asked the “patient” to perform certain physical tasks, such as raising and extending the arms, rapid hand-clapping and noted that he could see the response. By speaking with the “patient,” Schwamm could detect any drooping at the mouth, notice any slurred speech, and was able to use a video device for close-up views of the head and appendages. He was also able to converse easily with others in the room; in an actual emergency situation, a physician or nurse would be with the patient and immediately accessible to a MGH neurologist. The importance of a correct and rapid diagnosis cannot be overstated, Schwamm said. “What we say is ‘time is brain,’” he said. Critical Care at Critical Moments tPA [tissue plasminogen activator] is not the recommended treatment for all strokes, which means that determining that the event is ischemic, meaning caused by a blood clot, is extremely critical. The time factor underscores the need for prompt assessment, and the telemedicine system allows MGH physicians to review a patient’s brain scan and other tests, assess the patient through visual and verbal contact, and consult with NARH medical personnel in an on-the-spot fashion. The conferencing capability can expedite decisions about whether tPA is recommended, and if so, the medicine can be delivered without unnecessary delay. The system can also benefit patients affected by other types of stroke, such as hemorrhagic [bleeding] stroke, by ruling out ischemic stroke. tPA is not recommended for strokes caused by conditions other than blood clots. Prior to system implementation, patients affected by possible strokes would likely have been stabilized, telephone conferences may have occurred, but without the advantages of the telemedicine service, in many cases patients were transferred to other hospitals for evaluation via Lifeflight services. NARH is able to utilize local neurologist services, however, an area neurologist is not always available. The process could devour precious minutes, and the three-hour window could, in some cases, be closed. Saving Time = Saving $$$ Time is not only brain, but money. According to Schwamm, every patient successfully treated with tPA saves about $4,000 in medical costs, and the savings may be even greater because of reduced disability and continuing care expenses. According to information available at the MGH Web site, 794 individuals per 100,000 have had a stroke, and 80 percent of all strokes are ischemic. The North Adams Hospital was recently designated as a stroke treatment center by the state Department of Public Health. About a dozen state-based hospitals are linked to the stroke services system; the Franklin Medical Center in Greenfield is currently the closest facility to NARH using the system. The MGH stroke services system is also used internationally, and Massachusetts is the first state to offer the services on a wide-scale basis. Schwamm said that in the U.S., several entities are using or implementing telemedicine networks on a smaller scale. Wave of the Future Telemedicine has tremendous potential to impact other medical arenas and the technology is expected to expand and grow, Schwamm said. Medical specialties such as dermatology, pathology, especially in the area of oncology, and psychiatry are utilizing the technology, he noted. “This is the wave of the future and will hopefully become the wave of the present,” he said. Stroke Symptoms Stroke symptoms may include sudden weakness or numbness of the face, arm, or leg, which most often affects one side of the body, sudden confusion, difficulty speaking or comprehending others who are speaking, difficulty seeing that affects one or both eyes, sudden difficulty with walking, loss of balance, dizziness, and an abrupt onset headache with no apparent cause. Stroke symptoms may vary and symptoms depend on which side of the brain is involved, which portion of the brain is affected, and the severity of any damage. Symptoms may differ from person to person. Anyone who believes they are experiencing a stroke should seek medical assistance immediately. Risk factors for stroke include smoking, high blood pressure, high blood cholesterol levels, obesity and a sedentary lifestyle. Age, gender, and family history may also play a role in assessing stroke risk. Susan Bush may be reached at 802-823-9367 or by e-mail at
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Cultural Pittsfield This Week: Aug. 2-8

Enjoy 18 different art shows featuring work by more than two dozen accomplished regional and student artists in Pittsfield's bustling Upstreet Cultural District during the First Friday Artswalk and all month long! 
In most venues, artists will be present from 5-8 p.m. A free guided tour begins at 5 p.m. at the Intermodal Center @ BRTA, 1 Columbus Ave.
The Lichtenstein Center for the Arts will host HAPPY, an abstract art show by Jesse Tobin McCauley for the month of August. There will be an opening reception during First Fridays Artswalk from 5-8 p.m. The exhibit runs through August 31.
Kids and teens, pick up the August 2nd Scavenger Hunt flyer for a chance to win a prize! Grab yours at the Artswalk table in Crawford Square, 137 North St., during the Artswalk or print one from the website.
Berkshires Jazz brings five of the most popular regional bands to the stage for the 2019 Berkshire Jazz Showcase, on the Pittsfield Common from 12-5 p.m. The wide-ranging lineup for this jazz extravaganza includes Gina Coleman and Misty Blues, Paul Green and Two Worlds, Andy Wrba's Berkshire Jazz Collective,
First Take with Mary Ann Palermo and the Kyle Murray Quintet. FREE.
Hancock Shaker Village welcomes Berkshire Opera Festival as they pay homage to American opera by composers such as Leonard Bernstein, Aaron Copland and Carlisle Floyd. The recital, "Ain't it a Pretty Night," will feature soprano Caroline Worra, tenor John Riesen and pianist Lynn Baker will explore this essential part of the musical fabric of our country. 7:30 p.m. $18-$25.
FRI WordXWord Festival: Crosstalk at Tyler Street Lab | FRI Grahm Sturz at Hotel on North FRI Blue Light Trio at Rainbow | FRI Anthony Luchi at Rusty Anchor | FRI Sawyer Country at Proprietor's Lodge | FRI Karaoke Night at Friends | SAT WordXWord Festival: Accomplice[d] at Berkshire Museum | SAT Orin Swift Cellars Wine Tasting at Hotel on North | SAT Melissa Brinton at Rusty Anchor | SAT Jason & Trev at J. Allen's | SAT Uncensored Comedy Show at Uncorked | SUN Country Dance w/Spurs USA at Italian American Club | SUN-MON Marilyn Maye at Barrington Stage | MON Jazz Night at Mission | TUE Wintergreen at Springside Park | TUE Open Mic Night at O'Laughlin's | WED Live on the Lake: Generation X at Onota Lake | WED Gruppo Mondo at Rainbow | THU Deja Again at Mazzeo's | THU Abandoned Building Brewery Beer Dinner at Hotel on North | THU The Picky B's at Mission

Based on the Oscar-winning DreamWorks animated film, Shrek The Musical is a Tony Award-winning fairytale adventure featuring all new songs from Jeanine Tesori (Thoroughly Modern Millie) and a side-splitting book by David Lindsay-Abaire. Shrek brings all the beloved characters you know from the film to the stage and proves there's more to the story than meets the ears. The Colonial Theatre through August 9. $35 and up.
ONGOING Hansel & Gretel at Berkshire Museum FRI WeeMuse: Adventures at Berkshire Museum FRI Designing with da Vinci at Berkshire Museum FRI Yoga for Kids at Berkshire Athenaeum FRI-THU Parenting Classes & Play Groups at 18 Degrees (formerly Berkshire Children & Families) SAT WeeMuse: Art Lab at Berkshire Museum SAT Health & Wellness Fair at 18 Degrees (formerly Berkshire Children & Families) SAT Chow Time at Berkshire Museum SAT Designing with da Vinci at Berkshire Museum SAT Child & Family Yoga at Onota Lake SAT da Vinci After Hours at Berkshire Museum SUN Discovery Tank Program at Berkshire Museum | MON Exploring Our World at Berkshire Museum MON Kindergarten Countdown at Berkshire Athenaeum MON Star Lab at Berkshire Athenaeum MON Cones with a Cop on The Common MON Stardust Cafe at Berkshire Athenaeum MON Swan Lake Dance Intensive at Cantarella School of Dance MON Auditions for Magic Tree House Kids at The Colonial MON+ KidsAct! at Barrington Stage TUE WeeMuse: Littlest Learners at Berkshire Museum TUE Designing with da Vinci at Berkshire Museum TUE Princess Songs & Popsicle Party at The Whitney TUE Project SpaceCRAFT: Planet Pinch Pots at Be TUE Screening of Monsters vs Aliens at Berkshire Athenaeum WED Little Gardeners of the Galaxy at Berkshire Athenaeum WED Uncharted Wild Animal Show at Berkshire Athenaeum WED Tie Dye on the Terrace at Berkshire Athenaeum | WED Creative Healing Workshop w/Funky Phoenix at Berkshire Museum THU Farm Friends at Hancock Shaker Village | THU Exploring Our World at Berkshire Museum THU Designing with da Vinci at Berkshire Museum THU Story Time at Berkshire Athenaeum THU Lego Lift Off at Berkshire Athenaeum
SAT Outdoor Yoga & Zumba at Onota Lake
Join Rachael from Berkshire Yoga Dance & Fitness every 1st and 3rd Saturday (June through August) for outdoor yoga and Zumba classes at Burbank Park on Onota Lake. Yoga begins at 9 a.m. and Zumba at 10:15 a.m. Come to one class or both! $10 suggested donation per class. Rain cancels.
FRI-THU Various Classes at Berkshire Running Center | FRI-THU Various Classes at Berkshire Family YMCA | FRI-THU Various Classes at Berkshire Yoga Dance & Fitness FRI-THU Various Classes at Radiance Yoga | FRI-THU Various Classes at Berkshire Salsa FRI-THU Various Classes at Pilates Fit | SAT Sunrise Yoga on the Deck at Rusty Anchor | SUN Guido's Great 8 Road Race | TUE Summer Fit Training at Berkshire Yoga Dance & Fitness | THU Outdoor Yoga at Onota Lake
ONGOING If I Forget at Barrington Stage
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