Remote ultrasound scan could improve stroke outcomes

1st May 2014

Specialists may be able to carry out a life-saving diagnosis on someone suffering a stroke hundreds of miles away, thanks to new technology being investigated in a research collaboration led by the University of Aberdeen and supported by Highlands and Islands Enterprise (HIE).

An ultrasound scanner connected to a state-of-the-art communication system will transmit images of the patient’s brain in real time to centrally based specialists, aiming to increase survival rates and minimise resulting disability.

The technology could be a lifeline for people living in remote parts of the country, where it can take several hours to travel to a city hospital for brain scanning and diagnosis.

If testing is successful, local ambulance crews could carry the new device, and once on the scene would remotely link to the stroke specialist’s computer using a 2G, 3G, 4G or satellite connection.

The specialist will then check the images and could in the future advise paramedics whether or not they should administer life-saving ‘clot-busting’ drugs.

“Ideally, stroke patients should receive these clot-busting drugs within 90 minutes of the onset of the stroke, but they can still be administered up to four-and-a-half hours later. Every fifteen minutes of delay counts,” explains Dr Alasdair Mort from the University of Aberdeen’s Centre for Rural Health based at Raigmore Hospital in Inverness. This can be difficult in urban areas - in rural areas it is almost impossible.”

Currently, someone who is having a stroke would have to be brought into hospital to be scanned and examined by an expert. This new technology could see the ambulance staff carrying out an ultrasound examination at the scene of the stroke, and the hospital expert could watch the output in real-time thanks to a new piece of technology called the Omni-Hub™, developed by Tactical Wireless, and currently being tested with healthy volunteers.

Peter Morton, Managing Director of Tactical Wireless, comments: “Our testing of the Omni-Hub™ system, supported by Highlands and Islands Enterprise, has confirmed that excellent data and voice communications can be established and maintained between a vehicle in transit or at the incident scene in the remotest parts of the Highlands and Islands and a specialist stationed at a hospital miles away, thus promoting an immediate response to the need for time sensitive lifesaving treatment.”

The Omni-Hub™ ‘grabs’ whatever mode of communication is available in that location at that time, whether it’s 2G, 3G, 4G, Wi-Fi or two types of satellite, to transmit the signal directly to the expert’s terminal. As well as viewing the scan, the specialist can guide the ambulance crew and ask questions to gain more information about the patient.

Dr Mort says: “It’s essential that a stroke victim is properly assessed, as you can’t give the clot-busting drug to people who’ve had a bleed in the brain. It can only be given to those who’ve got a clot. Around 85-90% of strokes are as the result of blockages, but 10-15% are bleeds.”

More than 130,000 people suffer a stroke in the UK every year, and 1.3m people are living with the effects of stroke.

“Many of those affected are under the age of retirement and maybe cannot work thereafter – so as well as the devastating personal effects, there is also an economic impact to society as a whole.”

The Highlands and Islands is home to a growing cluster of business, academia, and pioneering healthcare providers delivering internationally significant life science work. HIE is focusing on efforts to maximise the opportunities for the region and to support our reputation for expertise, innovation and manufacturing capabilities across digital healthcare, diagnostics, and natural products.

James Cameron Head of Life Sciences at HIE said: “The life changing research being carried out by the Centre for Rural Health is attracting global interest. In January this year HIE signed a memorandum of understanding with the Satellite Applications Catapult. Following on from this agreement HIE, and the Catapult, has invested £50,000 into the project. As well as consolidating the reputation of our region for digital technology skills and expertise there are potential additional impacts including attracting research work and manufacturing opportunities.”

The collaborative project involves funding from Highlands and Islands Enterprise, the University of Aberdeen’s dot.rural Digital Economy Hub, international energy and water firm TAQA and the Satellite Applications Catapult.

Ultrasound manufacturers Philips Healthcare and BK Medical are also assisting the team with their study. Philips’ high specification CX50 compact ultrasound system provides both the imaging quality required and extreme portability.

Philips Healthcare UK Managing Director Alex McFarlane comments: “Once we were approached about this exciting new approach, we were delighted to support the group”.

BK Medical, which is part of the Analogic Ultrasound Group, is providing an Ultrasonix Tablet Ultrasound system for this study. This system offers a new perspective in imaging with its innovative touchscreen tablet ultrasound platform. BK Medical UK Managing Director Geoff Pick says: “Analogic Ultrasound are delighted to be part of a rural initiative improving healthcare in remote locations.”

Gerry MacNeil, Managing Director of Inverness-based Health Science Solutions Ltd. (HSS) says: "HSS are thrilled to be asked to support such an important project here in the Highlands. Enabling the participation of the world leading ultrasound companies will enhance and ensure its success. It puts Inverness/Aberdeen firmly at the forefront of raising the standards of pre-hospital care, utilising and pushing the boundaries of technology."

There are other potential uses for the technology: the devices could also be used for other health assessments if made available in ambulances or local health facilities. The current project aims to prove that the devices can work in some of the most remote parts of the country.

The University of Aberdeen research team, based at the Centre for Rural Health in Inverness, consists of experts in the use of technology in emergency care, in stroke care and in imaging technology. The team is collaborating closely with local NHS clinicians and technology companies Tactical WIreless and Health Science Solutions.