Network cameras enable ambulances to provide the right care faster.

When a person has a stroke, getting the right care in time is crucial. Pre-hospital ICT Arena at Lindholmen Science Park (PICTA), in partnership with Sahlgrenska University Hospital, University of Borås, Ambulanssjukvården i Västra Götalandsregionen [Emergency Medical Services in Region Västra Götaland] and Chalmers University of Technology, wanted to find new ways for stroke patients to receive the appropriate care more quickly.

The solution was tested in full-scale simulations and installed for live initial clinical testing. In the simulations, the network video solution was shown to give the hospital staff a greater opportunity to diagnose patients correctly as soon as they were in the ambulance. Quicker assessment and treatment of a stroke save lives and reduces the potential negative after-effects, which can be life-long. They also give stroke survivors a better chance of living a highfunctioning life, while at the same time creating greater health-economic benefits for society at lower costs.

If a stroke is suspected, the standard routine is for the patient to be taken to the nearest hospital to eliminate any “blockage” in the brain using treatment to reduce blood clotting. If a scan at the time indicates a large blood clot causing blockage in a central blood vessel, the patient must be immediately transported to a university hospital in Sweden that can surgically remove the blood clot (thrombectomy). Half of all patients who receive this treatment within six hours recover completely, meaning they can live an independent life. But the effect is time-dependent – simply put, the faster the better.

In Region Västra Götaland, there is only one hospital that can perform thrombectomies – Sahlgrenska University Hospital. This treatment is given when a scan has shown a blockage (blood clot) in any of the major blood vessels of the brain. These patients are generally the ones with the greatest symptoms in terms of number and severity.

A network video solution was initially installed in a test ambulance, followed by three operational ambulances in Region Västra Götaland. Axis network cameras, coupled with the cloud-based AXIS Companion solution, designed for smaller installations, are installed in the ambulances.

Each ambulance has three fixed-mount network cameras. One camera is positioned so it can film the patient’s entire body from the feet upwards. A second is positioned to get close-ups of the patient’s face, while a third provides a side view and an image of the paramedic performing the examination. The positioning was chosen to enable stroke doctors (vascular neurologists) at the hospital to see both the body and the face as clearly as possible when making their assessment.

The advantages of Axis network cameras include their dependability, operational reliability and stability. The image quality is high, and the cameras are easy to handle and can be accommodated in the tight space of the ambulances.

“AXIS Companion offers a quick and easy way for us to test our concept. Axis also has a reliable and knowledgeable support service, which is incredibly valuable,” says Bengt Arne Sjöqvist, Professor of Practice in Healthcare Informatics at Chalmers University of Technology and Programme Manager for PICTA at Lindholmen Science Park.

“It gives the ambulance crew a sense of security to have a specialised stroke doctor with them via a video link. In addition to the direct support in assessment, it also provides training as it helps the ambulance crew become even better at identifying and assessing a stroke,” says Bengt Arne Sjöqvist.

“It may be difficult for the ambulance crew to assess the patient’s condition correctly in order to determine whether he or she should be sent to a nearby hospital for treatment to reduce blood clotting or directly to Sahlgrenska University Hospital for a thrombectomy,” says Lars Rosengren.

Getting the right care more rapidly increases the chance of the stroke victim being able to resume a fully functioning life after the stroke. It saves lives and reduces suffering for patients and their loved ones and provides great health-economic benefits to society in the form of lower disease costs. “Society saves SEK 400,000 for each stroke patient treated with a thrombectomy if the treatment can be given in time,” says Lars Rosengren.

Approximately 25,000 people suffer from strokes each year in Sweden. While it mainly affects older people, younger people can also be affected. It affects women and men equally. In 85 per cent of cases, the stroke is caused by a blockage or a blood clot, referred to as an ischaemic stroke. In the other 15 per cent of the cases, it is caused by bleeding on the brain, referred to as a haemorrhagic stroke.

Worldwide, one in six people are expected to have a stroke at some point in their lifetime. Even if a person survives a stroke, as many as 30 per cent develop life-long after effects and cannot resume living their previous life. They instead need help with everything ranging from managing day to day tasks to, at worst, lifelong care in sheltered housing. (Sources: Stroke.se, MedTech West, Prehospital ICT Arena)