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Telestroke

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https://www.readbyqxmd.com/read/28913684/-telemedicine-in-stroke-care
#1
REVIEW
L Breuer, S Schwab
Telemedicine is already widely used in many telestroke networks and ensures stroke treatment close to the patient's home in rural and medically underserved areas. This is particularly effective when telemedicine is integrated into a stroke unit concept. While telemedically based thrombolysis therapy has become routine practice for many years, practical implementation of comprehensive mechanical thrombectomy and the related processes remains challenging. The main tasks for the future further include development of a structured stroke aftercare system in neurologically underserved areas and permanent assurance of high-quality stroke care in telemedically connected sites...
September 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28877562/rate-of-stroke-mimics-over-telestroke
#2
Dong In Sinn, Sami Al Kasab, Chirantan Banerjee, Shelly Ozark
No abstract text is available yet for this article.
September 6, 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28870567/tele-neurology-in-sub-saharan-africa-a-systematic-review-of-the-literature
#3
REVIEW
Fred S Sarfo, Sheila Adamu, Dominic Awuah, Bruce Ovbiagele
BACKGROUND: The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. OBJECTIVE: To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28754832/benchmarking-telestroke-proficiency-page-to-needle-time-among-neurovascular-fellows-and-attendings
#4
Amanda L Jagolino-Cole, Shima Bozorgui, Christy M Ankrom, Arvind B Bambhroliya, Tiffany D Cossey, Alyssa D Trevino, Sean I Savitz, Tzu-Ching Wu, Farhaan S Vahidy
BACKGROUND AND PURPOSE: Formal telestroke training for neurovascular fellows (NVFs) is necessary because of growing use of telestroke technologies in the management of acute ischemic stroke; yet, educational approaches and training benchmarks are not formalized. Time between telestroke consultant page and tissue-type plasminogen activator administration (page-to-needle time, PTNT) can provide an objective measure of proficiency. We compared PTNT between NVFs and neurovascular attendings (NVAs) and evaluated changes in PTNT with experience...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28753069/door-to-needle-time-over-telestroke-a-comprehensive-stroke-center-experience
#5
Sami Al Kasab, Jillian B Harvey, Ellen Debenham, David J Jones, Nancy Turner, Christine A Holmstedt
BACKGROUND: The implementation of telestroke programs has allowed patients living in rural areas suffering from acute ischemic stroke to receive expert acute stroke consultation and intravenous Alteplase (tPA). The purpose of this study is to compare door to needle (DTN) time when tPA is administered at telestroke sites (spokes) through telestroke consultations compared to tPA administration at the comprehensive stroke center (hub). METHODS: Data on all patients who received intravenous tPA at the hub and spoke hospitals through a large telestroke program between May 2008 and December 2016 were collected...
July 28, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28749731/transfer-of-patients-in-a-telestroke-network-what-are-the-relevant-factors-for-making-this-decision
#6
Carsten M Klingner, Stefan Brodoehl, Laura Funck, Caroline C Klingner, Jörg Berrouschot, Otto W Witte, Albrecht Günther
Background/Introduction: Current telestroke network consultations are focused on decision-making in the hyperacute stage of stroke management. The two main questions in telestroke consultations are whether thrombolysis should be initiated and whether the patient should be transferred to a hub hospital. Although guidelines exist for initiating intravenous thrombolytic therapy, the question of whether patients should be transferred is far more elusive. MATERIALS AND METHODS: In this study, we investigated the factors involved in the decision to transfer stroke patients to a hub hospital...
July 27, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28742223/impact-and-implementation-of-a-sustainable-regional-telestroke-network
#7
Annemarei Ranta, Jeremy Lanford, Suzanne Busch, Carolyn Providence, Ivan Iniesta, Ian Rosemergy, Andrew Wilson, Pietro Cariga, Victoria Richmond, John Gommans
INTRODUCTION: Telestroke uses videoconferencing (VC) technology to allow off-site experts to provide stroke thrombolysis decision support to less experienced front line clinicians. This project aimed to assess the impact of a new telestroke service on thrombolysis rates and door-to-needle times in participating provincial hospitals and service resources to aid transition to a sustainably telestroke service. METHODS: This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'postr' (June 2016 to December 2016) implementation outcomes...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28691864/outcomes-following-telestroke-assisted-thrombolysis-for-stroke-in-ontario-canada
#8
Joan Porter, Ruth E Hall, Moira K Kapral, Jiming Fang, Ferhana Khan, Frank L Silver
Introduction Since 2002, the Ontario Telestroke Program has provided hospitals in under-served regions of the province the opportunity to offer intravenous thrombolysis with tissue plasminogen activator (IV tPA) to eligible patients. The purpose of this study was to determine whether telestroke-assisted IV tPA patients had similar risks of 7- and 90-day mortality, symptomatic intracerebral haemorrhage (sICH), and poor functional outcome compared to patients who received IV tPA with on-site expertise. Methods Data from two audits of patients with acute ischaemic stroke hospitalized in Ontario, Canada in 2010 and 2012 were analysed...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#9
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28574595/influence-of-hospital-type-on-outcomes-of-individuals-aged-80-and-older-with-stroke-treated-using-intravenous-thrombolysis
#10
Francisco Purroy, Ana Vena, David Cánovas, Pere Cardona, Dolores Cocho, Elisa Cuadrado-Godia, Angel Chamorro, Antonio Dávalos, Moisés Garcés, Meritxell Gomis, Jerzy Krupinski, Ernest Palomeras, Marc Ribó, Jaume Roquer, Marta Rubiera, Jordi Sanahuja, Júlia Saura, Joaquín Serena, Xavier Ustrell, Martha Vargas, Ikram Benabdelhak, Sonia Abilleira, Miquel Gallofré
OBJECTIVES: The aim of the study was to confirm the safety and effectiveness of using intravenous thrombolysis (IVT) with individuals aged 80 and older in routine practice in different hospital settings. DESIGN: Observasional registry. SETTING: Prospective multicenter population-based registry of acute stroke patients treated with reperfusion therapies in Catalonia, Spain (Sistema Online d'Informació de l'Ictus Agut). PARTICIPANTS: Individuals treated only with IVT (N = 3,231; 1,189 (36...
June 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28478980/use-of-geospatial-modeling-to-evaluate-the-impact-of-telestroke-on-access-to-stroke-thrombolysis-in-ontario
#11
Lauren Jewett, Ario Mirian, Ben Connolly, Frank L Silver, Demetrios J Sahlas
BACKGROUND: The treatment of acute ischemic stroke in Ontario is coordinated through a network of stroke centers, supplemented by emergency telemedicine consultations to nonstroke centers through the Ontario Telemedicine Network's province-wide Telestroke program. Using geoinformatics, we sought to evaluate the overall impact of Telestroke on access to stroke thrombolysis in Ontario. METHODS: Ontario population data (census) were used to overlay polygons created by Service Area Analysis using ArcGIS 10...
May 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28441928/canadian-stroke-best-practice-recommendations-telestroke-best-practice-guidelines-update-2017
#12
Dylan Blacquiere, M Patrice Lindsay, Norine Foley, Colleen Taralson, Susan Alcock, Catherine Balg, Sanjit Bhogal, Julie Cole, Marsha Eustace, Patricia Gallagher, Antoinette Ghanem, Alexander Hoechsmann, Gary Hunter, Khurshid Khan, Alier Marrero, Brian Moses, Kelley Rayner, Andrew Samis, Elisabeth Smitko, Marilyn Vibe, Gord Gubitz, Dariush Dowlatshahi, Stephen Phillips, Frank L Silver
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28391278/a-comparison-of-remote-and-bedside-assessment-of-the-national-institute-of-health-stroke-scale-in-acute-stroke-patients
#13
Andrey M Alasheev, Aleksey Y Andreev, Yuliya V Gonysheva, Maria N Lagutenko, Olga Y Lutskovich, Antonina V Mamonova, Elena V Prazdnichkova, Andrey A Belkin
INTRODUCTION: Telestroke videoconference for conducting the National Institute of Health Stroke Scale (NIHSS) is recommended when the facility of a direct bedside evaluation by a stroke specialist is not immediately available for hyperacute stroke assessment. However, some NIHSS-telestroke studies inherit systematic bias due to the subjective nature of NIHSS administration. We aimed to evaluate NIHSS telestroke assessment, while implementing measures to minimize subjectivity bias. PATIENTS AND METHODS: Ninety stroke patients within 48 h of onset were assessed by 6 stroke neurologists grouped in 15 pairs...
2017: European Neurology
https://www.readbyqxmd.com/read/28384148/provision-of-stroke-thrombolysis-services-in-new-zealand-changes-between-2011-and-2016
#14
Qiliang Liu, Annemarei Anna Ranta, Ginny Abernethy, P Alan Barber
AIMS: To obtain an overall picture of the organisation of stroke thrombolysis provision in New Zealand hospitals and compare changes between 2011 and 2016. METHODS: Surveys were distributed to all New Zealand district health boards (DHBs) in 2011 and 2016, and included questions about the infrastructure, staffing, training, guidelines and audit provided for stroke thrombolysis. RESULTS: Responses were received from all DHBs, with 86% offering stroke thrombolysis in 2011 and 100% in 2016...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384077/american-telemedicine-association-telestroke-guidelines
#15
Bart M Demaerschalk, Jill Berg, Brian W Chong, Hartmut Gross, Karin Nystrom, Opeolu Adeoye, Lee Schwamm, Lawrence Wechsler, Sallie Whitchurch
The following telestroke guidelines were developed to assist practitioners in providing assessment, diagnosis, management, and/or remote consultative support to patients exhibiting symptoms and signs consistent with an acute stroke syndrome, using telemedicine communication technologies. Although telestroke practices may include the more broad utilization of telemedicine across the entire continuum of stroke care, with some even consulting on all neurologic emergencies, this document focuses on the acute phase of stroke, including both pre- and in-hospital encounters for cerebrovascular neurological emergencies...
May 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28366056/expanding-the-treatment-window-for-ischemic-stroke-through-the-application-of-novel-system-based-technology
#16
REVIEW
Mohammad El-Ghanem, Fawaz Al-Mufti, Venkatraman Thulasi, Inder Paul Singh, Chirag Gandhi
Recent randomized controlled trials have demonstrated the superiority of endovascular treatment (ET) over medical management in the treatment of acute ischemic stroke patients with anterior circulation emergent large vessel occlusions (ELVOs). Due to such accumulating evidence, expanding ET has become of paramount importance. Advancements in modern technology have enabled the use of mobile stroke units, telestroke networks, mobile neuroendovascular teams, and smartphone applications that shorten the time window to treatment and, thus, make patients more amenable to ET...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28222473/telemedizin-%C3%A2-tempis%C3%A2-netzwerk-f%C3%A3-r-schlaganfallbehandlung-in-der-regelversorgung
#17
REVIEW
Nicolas Völkel, Gordian J Hubert, Roman L Haberl
Despite all efforts that have been made stroke is a burden and remains one of the most devastating neurological diseases. Treatment of patients on a Stroke Unit improves stroke prognosis and is recommended for all patients with acute stroke. In rural areas population-wide implementation of Stroke Units is extremely challenging. Therefore the Telemedical Project for integrated Stroke Care (TEMPiS) was established in 2003 as a TeleStroke network to overcome this barrier in Southeast Bavaria/Germany. TEMPiS was one of the very early telemedical stroke networks worldwide and was evaluated intensively during its implementation phase between February 2003 and December 2005...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28170316/medical-university-of-south-carolina-telestroke-a-telemedicine-facilitated-network-for-stroke-treatment-in-south-carolina-a-progress-report
#18
Sami Al Kasab, Robert J Adams, Ellen Debenham, David J Jones, Christine Ann Holmstedt
BACKGROUND: Patients in rural communities lack access to acute stroke therapies. Rapid administration of lytic therapy increases the likelihood of favorable functional outcome in acute ischemic stroke (AIS). At the Medical University of South Carolina (MUSC), we implemented a Web-based telestroke program that allows patients presenting with AIS at a rural hospital to receive expert stroke consultation within minutes. This increases their chances of receiving lytic therapy, and therefore increases the likelihood of good functional outcome...
August 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28157754/remote-evaluation-of-the-patient-with-acute-stroke
#19
Bart M Demaerschalk
This article describes advances related to the successful remote evaluation of the patient with acute stroke. Telestroke is a connected care approach that brings expert stroke care to remote, neurologically underserved urban or rural locations. Recent findings reveal strong evidence showing that telestroke is equivalent to in-person care. Time is critical in treating patients with acute stroke, and telestroke networks must assure that technology improves-not delays-delivery of care. The stroke center and the spoke site must work collaboratively to develop and institute protocols and policies to ensure that eligible patients are identified, assessed, and treated swiftly...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28012837/feasibility-and-efficacy-of-nurse-driven-acute-stroke-care
#20
Shraddha Mainali, Sonja Stutzman, Samarpita Sengupta, Amanda Dirickson, Laura Riise, Donald Jones, Julian Yang, DaiWai M Olson
BACKGROUND: Acute stroke care requires rapid assessment and intervention. Replacing traditional sequential algorithms in stroke care with parallel processing using telestroke consultation could be useful in the management of acute stroke patients. The purpose of this study was to assess the feasibility of a nurse-driven acute stroke protocol using a parallel processing model. METHODS: This is a prospective, nonrandomized, feasibility study of a quality improvement initiative...
December 21, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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