Howard Memorial Hospital in Nashville Joins UAMS-Led Program to Provide Emergency Stroke Care

By David Robinson

Called Arkansas SAVES (Stroke Assistance Through Virtual Emergency Support), the program uses a high-tech video communications system to help provide immediate, life-saving treatments to stroke patients 24 hours a day. The real-time video communication enables a stroke neurologist to recommend emergency room physicians use a powerful blood thinner within the critical 4.5-hour period following the first signs of stroke.

The SAVES program is a partnership between the UAMS Center for Distance Health, the state Department of Human Services, Sparks Regional Health System in Fort Smith, Howard Memorial and 17 other Arkansas hospitals.

“This partnership gives us an opportunity to enhance the high level of quality care that the citizens of Howard County and the surrounding area can find at Howard Memorial,” said Debra J. Wright, CEO of Howard Memorial. “We’re committed to helping reduce the number of deaths and disabilities in Arkansas caused by stroke each year and are excited to be a part of this important initiative.”

“This is an important part of UAMS’ mission – reaching out to other areas of the state and helping local physicians identify patients with stroke and improve the patients’ outcomes,” said UAMS’ Salah Keyrouz, M.D., a stroke neurologist and neurointensivist and the Arkansas SAVES medical director.

Arkansas leads the nation in stroke mortality with 58.8 deaths per 100,000 population, according to the national Centers for Disease Control and Prevention. Arkansas had 1,884 stroke-related deaths in 2006. The nationwide direct and indirect cost of medical and institutional care of permanently disabled stroke victims was $62.7 billion in 2007, according to the American Heart Association’s 2010 Heart Disease and Stroke Statistics.

“The Arkansas SAVES program will save lives and money because if stroke patients get the treatment they need within 4.5 hours, they have a much greater chance of living without a major, costly disability,” said Julie Hall-Barrow, Ed.D., education director for the UAMS Center for Distance Health.

Stroke patients are at high risk of death or permanent disability, but patients who have an ischemic stroke can be helped with the blood-clot dissolving agent called t-PA. The drug must be given within 4.5 hours of the stroke and only to patients who have ischemic stroke caused by a blood clot, rather than a hemorrhagic stroke caused when a blood vessel ruptures and bleeds into surrounding brain tissue.

The Arkansas SAVES system relies on the state Health Department’s hospital preparedness high-speed video network transmission lines that provide the live, video communication necessary to link an on-call neurologist with a local hospital physician who is caring for a stroke patient.

Seventeen other Arkansas hospitals are participating in the SAVES program: Baptist Health Medical Center – Arkadelphia, White River Medical Center in Batesville, Baxter Regional Medical Center in Mountain Home, Booneville Community Hospital, DeWitt Hospital, Johnson Regional Medical Center in Clarksville, McGehee-Desha County Hospital, Mena Regional Health System, Helena Regional Medical Center, Saint Vincent Medical Center/North in North Little Rock, White County Medical Center in Searcy, Ashley County Medical Center in Crossett, Arkansas Methodist Medical Center in Paragould, Washington Regional Medical Center in Fayetteville, Crittenden Regional Hospital in West Memphis, Ozark Health Medical Center in Clinton and Saline Memorial Hospital in Benton.

The SAVES program will continue adding hospitals across Arkansas in the coming months, said Curtis Lowery, M.D., director of the UAMS Center for Distance Health.
He said it’s important that the public be aware of the signs and symptoms of a stroke, such as sudden weakness, numbness, unsteady gait, and visual and speech problems.

Since the program began Nov. 1, 2008, 39 patients have received t-PA following consultation with a SAVES neurologist. Another 171 patients seen by SAVES neurologists did not qualify for t-PA, either because they arrived beyond the 4.5 hour threshold, had a hemorrhagic rather than ischemic stroke, or were diagnosed with other conditions.

In addition to Keyrouz, the team includes: Margaret Tremwel, M.D., a stroke neurologist at Sparks Regional Health System in Fort Smith, Sami I. Harik, M.D., a UAMS stroke neurologist, and Vladimir Karpitskiy, M.D., Ph.D., a stroke neurologist in Hot Springs and adjunct faculty in the UAMS College of Medicine.

UAMS is the state’s only comprehensive academic health center, with colleges of Medicine, Nursing, Pharmacy, Health Related Professions and Public Health; a graduate school; a 540,000-square-foot hospital; six centers of excellence and a statewide network of regional centers. UAMS has 2,775 students and 748 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is the state’s largest public employer with more than 10,000 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. Visit or