Bringing High Tech Virtual Health Care to Rural America
For the fourth time, the USDA has awarded Mercy a substantial grant that will provide greater access to health care in some of Mercy’s most rural communities in Arkansas, Kansas, Missouri and Oklahoma..Story by Ellis Kmetzsch
Dillion Kirkland is a 31-year-old Mercy emergency medical technician who works with life-threatening injuries and illnesses every day. Last October, he found himself on the receiving end of care when he was taken to the emergency department by his own co-workers after he experienced a stroke. Kirkland’s story reinforces the importance of stroke awareness and treatment through in-person and virtual care.
Kirkland was in the driver’s seat of an ambulance after a routine patient transfer when he started feeling strange. He asked his partner, Brian Ridgway, to take the wheel. But after arriving back in Ada, Oklahoma, his symptoms continued to worsen. Kirkland’s paramedic partner recognized something was seriously wrong and loaded him up in his own ambulance and took him straight to the ER.
“Brian told me, ‘I think you’re having a stroke,’ but I thought, ‘I’m 31, I can’t be having a stroke,’” said Kirkland. “Even with all my training and experience, I couldn’t process what was happening. It progressed to where I couldn’t speak, I couldn’t formulate a sentence, everything was garbled and delayed. What I wanted to say in my brain just wouldn't come out of my mouth.”
According to the Centers for Disease Control and Prevention, someone experiences a stroke every 40 seconds in the United States, and stroke remains one of the leading causes of death and long-term disability. While stroke risk increases with age, a stroke can occur at any age.
After Kirkland arrived in the Mercy Hospital Ada emergency department, he was evaluated and connected with a Mercy Virtual neurologist. Sensing the urgency of the situation, the virtual neurologist rushed the local team to administer a beta-blocker to lower blood pressure and a clot-dissolving stroke medication called Tenecteplase (TNK).
“Our team quickly evaluated Dillion and gave him the medication he needed,” said Dr. Advait Mahulikar, a member of Kirkland’s virtual neurology team. “The quick actions and assessment of our team combined with clot-busting medication helped prevent the worsening of symptoms that could have potentially become disabling, especially at such a young age.”
Mercy Virtual has a team of neurologists who provide care 24/7 to 31 Mercy facilities across four states. Depending on a hospital’s needs, Mercy Virtual supplements in-person neurology care or provides full neurology coverage for many rural hospitals unable to staff full-time physicians. This allows the local team to work collaboratively at a patient’s bedside without spending extra time transporting them to larger trauma centers.
“Virtual care has literally changed the lives of thousands of patients by providing access to a neurologist when it matters most during a time-sensitive diagnosis like stroke,” said Dr. Meghan Rodden, physician lead of Mercy Virtual stroke care. “Time is brain, and a typical patient can lose 1.9 million neurons each minute a stroke is untreated. That is why it’s essential that our virtual neurologists do a combination of bedside and virtual work so some of our smaller facilities can get access to the specialized care they need faster.”
With the help of his in-person and virtual care team, Kirkland’s story has a happy ending.
“After the TNK medication was administered, my symptoms were resolved within 30 minutes, and I’ve fully recovered with no deficits to this day,” he said. “TNK was actually a relatively new standard of stroke care. It was something we had recently discussed as an EMS team, but I had yet to see it in action, so it was scary to try it myself firsthand. I’m a firm believer in TNK now.”
While Kirkland didn’t have the typical stroke symptoms of one-sided weakness, he had overall coordination loss, garbled speech and an extremely elevated blood pressure. Mercy recommends the acronym B.E.F.A.S.T. if someone is believed to be having a stroke.
- B – Balance: Does the person complain of sudden dizziness or difficulty walking?
- E – Eyes: Does the person complain of blurred vision, seeing dark or bright spots?
- F – Face: Ask the person to smile. Is the smile even or lop-sided?
- A – Arms: Ask the person to raise both arms. Does one arm drift downward?
- S – Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
- T – Time: If you see any of these signs, call 9-1-1 right away and note the time
Observers should record the time when any symptoms first appear to help health professionals plan the best treatment and minimize long-term stroke damage.
Kirkland is back at work saving lives, but he hopes sharing his story will help spread awareness.
“Knowing the signs is important for everyone and can make a big difference in recovery or even between life and death,” Kirkland said. “When in doubt, call 9-1-1 and seek medical attention.”
