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Erlanger leads “history making” breakthrough in stroke treatment

Certificate Presentation

Certificate Presentation

Erlanger’s stroke team played a key role in a breakthrough treatment for acute stroke, following a series of successful clinical trials hailed as representing “a new era” and “sea change” in stroke treatment around the world.

Dr. Tom Devlin, Chairman of Erlanger’s Neurosciences Department, along with Dr. Blaise Baxter, Chief Neurointerventional radiologist at Erlanger and Dr. Biggya Sapkota, neurologist and co-director of the Erlanger Southeast Regional Stroke Center, principal investigators in worldwide stroke research trials, recently reported the impressive results of their research work at an Erlanger press conference this week.

Dr. Devlin and Dr. Baxter

Drs. Tom Devlin and Blaise Baxter

The three specialists announced that Erlanger’s stroke team was honored this month at the International Stroke Conference (ISC) for enrolling more stroke patients than any of the 68 international study sites, achieving the best medical outcomes among all the centers participating in the international study and setting a benchmark for the fastest treatment times – outperforming every other global participant in the study.

The history-making result of the international clinical trials is that endovascular treatment has become the new standard of care for acute or ischemic stroke. Neurointerventional radiologist Dr. Blaise Baxter, explained that this new treatment of choice involves the use of tiny “clot plucking” or “clot sucking” extractors threaded through a stroke patient’s blood vessels to remove blood clots on the brain.  Since 1996, a clot-dissolver drug has been a standard treatment for stroke patients – one that has not been proven effective for large vessel blood clots.

“For the last 20 years, we’ve had a complete blackout in new and approved stroke treatment,” Dr. Devlin told reporters, noting that the new standard of care for stroke “represents a historic day and the culmination of work we have done since 1999.”

During the press conference, reporters were shown videos of several patients upon arrival at Erlanger’s stroke center and immediately following their endoscopy procedures. One was an 83-year old man who was fully alert and talking after his treatment and who “would probably not have survived, or been in a nursing home without the endoscopy,” according to Dr.Baxter.

Previous detractors of this endovascular treatment method are now calling it “a sea change, a “new day in stroke” and “the biggest advance in stroke treatment since 1996.”  One self-professed skeptic, ISC program chair, said that the results of the trials are consistent and convincing, adding, “We are now obligated to use this technology in eligible stroke patients with a large vessel occlusion.”

Dr. Sapkota

Biggya Sapkota, MD, Director of Acute Stroke Services, Co-Director of Southeast Regional Stroke Center

Dr. Devlin addressing attendees

Tom Devlin, MD, PhD CCI, Department Chairman of Erlanger Neuroscience Department, Co-Director of Southeast Regional Stroke Center

Dr. Baxter

Blaise Baxter, MD, Chief Neurointerventional Radiologist at Erlanger

Eleven treated for weather-related injuries at Erlanger ER’s; Nine adults, two children seen before 9 a.m. Thursday

As of 9 a.m. Thursday, 11 area residents were treated for weather-related injuries at Erlanger Emergency Rooms. 

Eight adults were treated for a variety of injuries at Erlanger’s downtown ER, four from falls, two for injuries sustained in motor vehicle accidents, one from sledding and one individual whose foot was treated for frost bite.  Specific injuries included blunt abdominal trauma, a lumbar spine fracture, head laceration, dislocated shoulder, arm injury, wrist fracture and heart arrhythmia.  Two of those patients were admitted to the hospital.

Two children were treated at Children’s Hospital at Erlanger, one who suffered a closed head injury in an ATV accident and another with a fall-related arm injury.  One child was admitted to the hospital.

Another adult was treated and released at the Erlanger North Hospital Emergency Room for an acute dislocated shoulder as the result of a fall.

A follow up report will be issued as the week continues.

Medical trials affirm Erlanger’s place at ‘forefront of stroke treatment’

(From the February 26, 2015 Chattanooga Times Free Press) Stroke doctors at Erlanger Health System were all smiles as they stood before their colleagues in a conference room on Tuesday.

“As you can see, we’re in a very celebratory mood,” said Dr. Blaise Baxter, chief neurointerventional radiologist at the hospital. “This is a historic day, and it represents the culmination of work we’ve done since 1999.”

Historic is a word “we don’t use lightly,” said Dr. Tom Devlin, chairman of Erlanger’s neurosciences department.

The hospital is heralding its role in a breakthrough in acute stroke treatment, as a series of successful clinical trials will soon “usher in a new era for stroke treatment,” Devlin said.

The treatment, known as endoscopy, uses tiny devices threaded through a stroke victim’s blood vessels to fish out blood clots in the brain. At Erlanger, the method has been a standard part of treating the most severe strokes since the late 1990s.

But while those doctors say they consistently see the treatment’s benefit to patients in their day-to-day work, medical research has never existed to make the practice standard. Since 1996, the clot dissolver known as tPA has been the only stroke treatment typically relied upon by hospitals — even though it is not effective for large-vessel strokes.

“For the last 20 years, we’ve had a complete blackout in new and approved stroke treatment,” Devlin said Tuesday.

That has changed over the last two years. Four clinical stroke trials, including two done at Erlanger, showed “overwhelmingly positive” results, proving that using the devices to remove the clots in large vessels left patients in far better condition than those who were given tPA alone. The results of the studies were released at the International Stroke Conference in Nashville earlier this month.

The studies have major implications for patients, the doctors say. Such care is now on the way to becoming standardized, as the FDA changes device labeling and guidelines for physicians. Instead of being considered investigational, the procedure now will be recommended.

At a news conference Tuesday, physicians showed videos of patients during stroke — when they cannot speak coherently or move their limbs — and shortly after the procedure, when they are talking normally and moving fine.

“This is a patient who would probably not survive, or would likely be in a nursing home afterward,” Baxter said, describing one 83-year-old stroke patient who was smiling and talking after his procedure.

Physicians at the International Stroke Conference told MedScape Medical News that the new trial results signaled “sea change — a new day in stroke” and “the biggest advance in stroke treatment” since tPA was introduced in 1996.

The conference program chairwoman, Dr. Kyra Becker, a self-professed skeptic about endovascular treatment for stroke, told Medscape that the data from the trials “are consistent and convincing. We are now obligated to use this technology in eligible stroke patients with a large vessel occlusion.”

Erlanger doctors were honored at the conference for enrolling more patients than any of the other 68 international study sites, achieving the best medical outcomes among all the centers participating in this international study and setting a benchmark for the fastest treatment times, outperforming every other global participant in the study.

Contact staff writer Kate Belz at kbelz@timesfreepress.com or 423-757-6673.

The EROC Era

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After 8 months of construction, our region has officially entered the “EROC Era.” EROC (Erlanger Regional Operations Center) is a new, high-tech control center that will greatly improve patient care, particularly in the emergency response and pre-hospital care sectors.

The EROC center is full of “pods” that are equipped with multiple screens and state-of-the-art technology that shows important information like videos of air ambulances or the availability of patient resources.

EROC Work Station1

In one pod, Puckett EMS will dispatch ambulances. In the next one, operators will be ready to work in the event of a disaster. Another pod will control patient care within the hospital (for example, when someone’s room is cleaned, when they’re moved, when their blood is tested, etc). Having all these advanced tools in one place will make all the difference.

EROC will be the nucleus for pre-hospital experiences across the region. It will coordinate communication throughout 13 counties, including 10 in Southeast Tennessee and 3 in Georgia. Center workers will have access to simpler coordination with other regional communication centers.

As the most advanced communication center in the country, EROC will serve as a model to pre-hospital and emergency response centers across the nation.

In the words of Tennessee Congressman Chuck Fleischmann, “This is another great Erlanger moment.”

Erlanger connects the present with the future in a new Regional Operations Center

Erlanger and state officials, as well as emergency response representatives, formally connected the present with the future as they showcased the latest technology in providing faster, more convenient and the most comprehensive medical coverage in our area.

Erlanger Regional Operations Center (EROC) houses LIFE FORCE flight operations, the Tennessee Regional EMS Medical Communications Center, Erlanger’s transfer and patient placement center, and Erlanger’s ambulance transport provider, Puckett EMS.  It also includes other vital functions that enhance EMS pre-hospital medical control and transport, patient throughput and the region’s Disaster Medicine Operations.

“We are extremely proud to open this new center which provides state-of-the-art communications for all pre-hospital emergency transportation including air traffic control of air ambulances and Hamilton County EMS medical control,” said Erlanger President and CEO, Kevin M. Spiegel, FACHE.  “The center is also directly linked to bed placement throughout the healthcare system to enhance the smooth operation of patient placement and patient throughput,” he added.

The Erlanger-Chattanooga MedComm is a designated Regional Medical Communication Center by the State of Tennessee Office of Emergency Medical ServicesThe center coordinates all communication within Region 3 (Southeast Tennessee) and in cooperation with adjoining regions.  Receiving approximately 37,000 calls per year for emergency services, staff members at the center coordinate pre-hospital communications between EMS and healthcare providers, serve as the pre-hospital EMS coordination point for Mass Casualty Incident Transport Officers, communicate between Tennessee and Georgia EMS and public health officials during incidents that could impact healthcare in our region and provide support for EMS services entering the area from other regions or states.

Since 1988, LIFE FORCE has provided air medical services in the region for Erlanger Health System.  The program operates four helicopters and services four states.  Accredited by the commission for medical transport since 2011, LIFE FORCE is nationally ranked as one of the highest performing air medical services in the country.  LIFE FORCE receives approximately 5,000 calls a year requesting medical air transport service.  Depending on weather, medical care and other flight conditions, LIFE FORCE operates approximately 2,000 flights each year.  It is the only air ambulance program in our region that carries ultrasound, blood and plasma and is credentialed by physicians at Erlanger to perform emergency surgical procedures.  All LIFE FORCE flight nurses and paramedics have board certification in critical care transport.  LIFE FORCE is one of only 5% of the programs in the country that has achieved this standard.

LIFE FORCE Crew Members

Audience during EROC Event

EROC Work Station 2EROC Signage

Sneak preview of the new Erlanger Regional Operations Center Friday, February 20

Erlanger and state officials, as well as emergency response representatives, will formally connect the present with the future as they showcase the latest technology in providing faster, more convenient and the most comprehensive medical coverage in our area this Friday at 11 a.m. at Erlanger.

Erlanger Regional Operations Center (EROC) will house LIFE FORCE flight operations, the Tennessee Regional EMS Medical Communications Center, Erlanger’s transfer and patient placement center, and Erlanger’s ambulance transport provider, Puckett EMS.  It will also include other vital functions that enhance EMS pre-hospital medical control and transport, patient throughput and the region’s Disaster Medicine Operations.

“We are extremely proud to open this new center which will provide state-of-the-art communications for all pre-hospital emergency transportation including air traffic control of air ambulances and Hamilton County EMS medical control,” said Erlanger President and CEO Kevin M. Spiegel, FACHE.  “The center is also directly linked to bed placement throughout the healthcare system to enhance the smooth operation of patient placement and patient throughput,” he added.

Fast Facts: Erlanger Regional Operations Center (EROC)

  • MedComm services 10 Tennessee counties and three North Georgia counties.
  • MedComm receives approximately 37,000 calls per year for emergency services.
  • Erlanger’s Transfer Center receives on average 13,000 calls per month for medical service to patients.
  • Between 700 and 800 calls are received every year connecting specialists with other physicians for pre-hospital assistance.
  • LIFE FORCE receives approximately 5,000 calls a year requesting medical air transport service.
  • Depending on weather, medical care and other flight conditions, LIFE FORCE operates approximately 2,000 flights each year.
  • All LIFE FORCE flight nurses and paramedics are board certificated in critical care transport.  LIFE FORCE is one of only 5% of the programs in the country that has achieved this standard.

Bringing a New Orthopedic Center to Chattanooga

Center for Orthopedic Surgery Fulfills Significant Community Need

Every patient about to go to under the knife appreciates the expression “surgical precision.” Recently, the patient was Erlanger Hospital’s sixth floor, and the doctors had diagnosed the facility as missing a critical component— a dedicated orthopedic services area.

For this particular operation, our doctors temporarily replaced their precision instruments with something a little more blunt: sledgehammers. Erlanger President and CEO Kevin M. Spiegel, FACHE, began the procedure, and his team assisted him in tearing down a wall, beginning construction of Erlanger’s new Center for Orthopedic Surgery.

Mr. Spiegel knew how long the assembled doctors had been waiting for this day. “Our orthopedic and sports medicine specialists were so anxious to see this construction begin, they wanted to personally kick off this first phase of Erlanger’s expansion efforts by making their own mark on the re-build.”

One of those happiest about the construction is Dr. Mark Freeman, who had urged creation of such a center for five years. He followed his eight sledgehammer blows by saying, “I’ve been waiting to do that a long time…it’s a great day for me and my colleagues, but most importantly for Erlanger and its patients in the region.”

Part of a larger $71 million expansion project, the $9.5-million Center will include four operating rooms, twelve beds, pre-op and post-op areas, a waiting room and more.

“You can have the best car in the world, or the best driver in the world, but you need both to be successful. We’ve had the best drivers for a long time, and now we’ll have the best car, too,” said Freeman

Once Erlanger has both, we’ll be in a better position to serve the community’s and region’s orthopedic needs. Publications have recognized Chattanooga as a premier city for outdoor activities, and with so many native and visiting athletes, explorers and adventurers of all ages, there is a great need for the new, comprehensive facility.

Mr. Spiegel acknowledged that need by saying, “This marks a new phase of Erlanger’s future that will meet the hospital’s infrastructure needs with world-class facilities unparalleled in the region, and will help our patients achieve their goals to return to normal, more active states.”

Dr. Bill Moore Smith goes on to explain just how advanced and comprehensive this new Orthopedic Center will be, to meet the area’s increasing demand.

The Erlanger Center for Orthopedic Surgery will open in 2015.

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