Dutch ambulances give stroke suspects real-time video access to neurologists

In the service area of the regional ambulance service (RAV) Hollands Midden, a neurologist can be connected to a patient going through a suspected stroke with the press of a button. This summer, a trial began in Leiden, Leiderdorp, Gouda, and Alphen aan den Rijn, according to AD.

"The neurologist on duty receives a kind of NL-Alert notification on his or her phone,” Nyika Kruyt, neurologist at Leiden University Medical Center (LUMC), told AD. Within 30 seconds, the nurse sets up a video call via Teams, which allows the expert to observe the patient.

Unlike the ambulance nurse, Kruyt can look through the patient’s medical record and ask specific questions. Therefore, preliminary diagnosis and advice can be given in about five minutes.

This means that when necessary, the ambulance can immediately drive to the LUMC when the patient can receive specialized treatment not available at regional hospitals.

Saving time is crucial during a stroke. “Every second, a million brain cells are lost. Then people have less chance of recovering well,” Kruyt said.

This approach, known as telestroke triage, was developed by the acute-care partners in the Hollands Midden region. The region ambulance service (Hecht RAV Hollands Midden) is working with Leiden University Medical Center, Alrijne Hospital, and Groene Hart Hospital in Gouda. Triage means quickly assessing how urgent a patient's condition is and deciding the best level of care.

“Ambulance care in the Netherlands is good, but we are not specialists. So it’s fantastic that I can now reach a neurologist when I’m in doubt. You really save time,” said Lennert Kulker, physician assistant with the ambulance service that tested the system.