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Telestroke

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https://www.readbyqxmd.com/read/27899742/acute-endovascular-treatment-delivery-to-ischemic-stroke-patients-transferred-within-a-telestroke-network-a-retrospective-observational-study
#1
Jessica Barlinn, Johannes Gerber, Kristian Barlinn, Lars-Peder Pallesen, Timo Siepmann, Charlotte Zerna, Claudia Wojciechowski, Volker Puetz, Rüdiger von Kummer, Heinz Reichmann, Jennifer Linn, Ulf Bodechtel
BACKGROUND: Five randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their role in patients undergoing endovascular treatment is unknown. AIM: We compared clinical outcomes of endovascular treatment between anterior circulation stroke patients transferred after teleconsultation and those directly admitted to a tertiary stroke center. METHODS: Data derived from consecutive patients with intracranial large vessel occlusion who underwent endovascular treatment from January 2010 to December 2014 at our tertiary stroke center...
November 29, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27887976/the-establishment-of-a-telestroke-service-using-multimodal-ct-imaging-decision-assistance-turning-on-the-fog-lights
#2
REVIEW
Jelle Demeestere, Claire Sewell, Jennifer Rudd, Timothy Ang, Louise Jordan, James Wills, Carlos Garcia-Esperon, Ferdinand Miteff, Venkatesh Krishnamurthy, Neil Spratt, Longting Lin, Andrew Bivard, Mark Parsons, Christopher Levi
Telestroke services have been shown to increase stroke therapy access in rural areas. The implementation of advanced CT imaging for patient assessment may improve patient selection and detection of stroke mimics in conjunction with telestroke. We implemented a telestroke service supported by multimodal CT imaging in a rural hospital in Australia. Over 21months we conducted an evaluation of service activation, thrombolysis rates and use of multimodal imaging to assess the feasibility of the service. Rates of symptomatic intracranial haemorrhage and 90-day modified Rankin Score were used as safety outcomes...
November 22, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27834751/stroke-thrombolysis-in-a-centralized-and-a-decentralized-system-helsinki-and-telemedical-project-for-integrative-stroke-care-network
#3
Gordian J Hubert, Atte Meretoja, Heinrich J Audebert, Turgut Tatlisumak, Florian Zeman, Sandra Boy, Roman L Haberl, Markku Kaste, Peter Müller-Barna
BACKGROUND AND PURPOSE: Intravenous thrombolysis with tissue-type plasminogen activator (tPA) for acute ischemic stroke is more effective when delivered early. Timely delivery is challenging particularly in rural areas with long distances. We compared delays and treatment rates of a large, decentralized telemedicine-based system and a well-organized, large, centralized single-hospital system. METHODS: We analyzed the centralized system of the Helsinki University Central Hospital (Helsinki and Province of Uusimaa, Finland, 1...
November 10, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27811332/telemedicine-quality-and-outcomes-in-stroke-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#4
Lawrence R Wechsler, Bart M Demaerschalk, Lee H Schwamm, Opeolu M Adeoye, Heinrich J Audebert, Christopher V Fanale, David C Hess, Jennifer J Majersik, Karin V Nystrom, Mathew J Reeves, Wayne D Rosamond, Jeffrey A Switzer
PURPOSE: Telestroke is one of the most frequently used and rapidly expanding applications of telemedicine, delivering much-needed stroke expertise to hospitals and patients. This document reviews the current status of telestroke and suggests measures for ongoing quality and outcome monitoring to improve performance and to enhance delivery of care. METHODS: A literature search was undertaken to examine the current status of telestroke and relevant quality indicators...
November 3, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27805298/telestroke-imaging-a-review
#5
Fahad J Laghari, Maxim D Hammer
The use of telecommunications technology to provide the healthcare services, telemedicine, has been in use since the 1860s. The use of technology has ranged from providing medical care to far-off places during wartimes to monitoring physiological measurements of astronauts in space. Since the 1990s, reports have been published on diagnoses of neurological diseases with the use of video links. Studies confirm that the neurological examinations, including the National Institutes of Health Stroke Scale, performed during teleneurology are dependable...
November 2, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27782019/whatsapp-in-clinical-practice-a-literature-review
#6
Maurice Mars, Richard E Scott
: Several spontaneous telemedicine services using WhatsApp Messenger have started in South Africa raising issues of confidentiality, data security and storage, record keeping and reporting. This study reviewed the literature on WhatsApp in clinical practice, to determine how it is used, and users' satisfaction. METHODS: Pubmed, Scopus, Science Direct and IEE Expert databases were searched using the search term WhatsApp and Google Scholar using the terms WhatsApp Telemedicine and WhatsApp mHealth...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/27672174/telestroke-is-it-safe-and-effective
#7
Maya Madhavan, Steven Karceski
No abstract text is available yet for this article.
September 27, 2016: Neurology
https://www.readbyqxmd.com/read/27625233/advantages-of-telestroke-in-rural-areas
#8
Adrià Arboix, María José Sánchez
No abstract text is available yet for this article.
September 2016: Neurology India
https://www.readbyqxmd.com/read/27625232/telestroke-in-resource-poor-developing-country-model
#9
Sudhir Sharma, M V Padma, Amit Bhardwaj, Ashish Sharma, Nishit Sawal, Suresh Thakur
CONTEXT: Telemedicine is a major effort to tackle the uneven availability of facilities for thrombolysis in acute ischemic stroke. We present a telestroke model introduced in a small hilly state of Himachal Pradesh in India. AIMS: To provide acute ischemic stroke treatment with tissue plasminogen activator in all district hospitals of Himachal Pradesh with computerized axial tomographic scan facility through Telemedicine. SETTINGS AND DESIGN: Smartphone-based hub and spoke telestroke model was used with two tertiary care hospitals (with neurologists) as hub and 17 district hospitals (without onsite neurologists) as spokes...
September 2016: Neurology India
https://www.readbyqxmd.com/read/27599906/accuracy-of-stroke-diagnosis-in-telestroke-guided-tissue-plasminogen-activator-patients
#10
Kunal Agrawal, Rema Raman, Karin Ernstrom, Robert Joseph Claycomb, Dawn Matherne Meyer, Thomas Martin Hemmen, Royya Fatima Modir, Pranav Kachhi, Brett Cowan Meyer
OBJECTIVES: The objective of the study is to assess the accuracy of final diagnosis in telestroke-guided tissue plasminogen activator (rt-PA) patients compared with bedside evaluation using computed tomography (CT) or magnetic resonance imaging (MRI) as a surrogate for final stroke diagnosis. The overall goal was to determine if telestroke had similar diagnostic accuracy as bedside evaluations in diagnosing rt-PA-treated patients. MATERIALS AND METHODS: We analyzed all acute stroke code calls who received intravenous rt-PA at our center from October 2013 to June 2015...
September 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27566746/safety-and-efficacy-of-thrombolysis-in-telestroke-a-systematic-review-and-meta-analysis
#11
Jessica Kepplinger, Kristian Barlinn, Stefanie Deckert, Madlen Scheibe, Ulf Bodechtel, Jochen Schmitt
OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the safety and efficacy of IV thrombolysis (IVT) with tissue plasminogen activator (tPA) delivered through telestroke networks in patients with acute ischemic stroke. METHODS: We conducted a systematic review and meta-analysis according to PRISMA guidelines. Literature searches on MEDLINE, Embase, and CENTRAL databases covered prospective randomized controlled and nonrandomized studies comparing telemedicine-guided IVT to IVT administered at stroke centers and were published from the earliest date available until April 1, 2015...
September 27, 2016: Neurology
https://www.readbyqxmd.com/read/27566739/telestroke-solid-support-for-virtual-acute-stroke-care
#12
EDITORIAL
Bart M Demaerschalk, Steven R Levine
No abstract text is available yet for this article.
September 27, 2016: Neurology
https://www.readbyqxmd.com/read/27491742/in-transit-telemedicine-speeds-ischemic-stroke-treatment-preliminary-results
#13
Gary H Belt, Robert A Felberg, Jane Rubin, John J Halperin
BACKGROUND AND PURPOSE: Time to treatment is critically important in ischemic stroke. We compared the efficacy and cost of teleneurology evaluation during patient transport with that of mobile stroke transport units. METHODS: Using cellular-connected telemedicine devices, we assessed 89 presumptive stroke patients in ambulances in transit. Paramedics assisted remote teleneurologists in obtaining a simplified history and examination, then coordinating care with the receiving emergency department...
September 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27479951/safe-and-effective-implementation-of-telestroke-in-a-us-community-hospital-setting
#14
Kori Sauser-Zachrison, Ernest Shen, Navdeep Sangha, Zahra Ajani, William P Neil, Michael K Gould, Dustin Ballard, Adam L Sharp
CONTEXT: There is substantial hospital-level variation in use of tissue plasminogen activator (tPA) for treatment of acute ischemic stroke. Telestroke services can bring neurologic expertise to hospitals with fewer resources. OBJECTIVE: To determine whether implementation of a telestroke intervention in a large integrated health system would lead to increased tPA utilization and would change rates of hemorrhagic complications. DESIGN: A stepped-wedge cluster randomized trial of 11 community hospitals connected to 2 tertiary care centers via telestroke, implemented at each hospital incrementally during a 1-year period...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27476342/older-stroke-patients-with-high-stroke-scores-have-delayed-door-to-needle-times
#15
Lee A Birnbaum, Jesse S Rodriguez, Christopher H Topel, Reza Behrouz, Vivek Misra, Santiago Palacio, Michele G Patterson, Deb S Motz, Martin W Goros, John E Cornell, Jean-Louis R Caron
INTRODUCTION: The timely administration of intravenous (IV) tissue plasminogen activator (t-PA) to acute ischemic stroke patients from the period of symptom presentation to treatment, door-to-needle (DTN) time, is an important focus for quality improvement and best clinical practice. METHODS: A retrospective review of our Get With The Guidelines database was performed for a 5-hospital telestroke network for the period between January 2010 and January 2015. All acute ischemic stroke patients who were triaged in the emergency departments connected to the telestroke network and received IV t-PA were included...
July 28, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27333939/drip-and-ship-thrombolytic-therapy-supported-by-the-telestroke-system-for-acute-ischemic-stroke-patients-living-in-medically-under-served-areas
#16
Teruyoshi Kageji, Fumiaki Obata, Hirofumi Oka, Yasuhisa Kanematsu, Ryo Tabata, Kenji Tani, Hiroyasu Bando, Shinji Nagahiro
There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Prefectural Kaifu Hospital (TPKH), located in rural Japan, can relay CT or MRI scans and other patient data via their smart phone to off-site stroke specialists...
June 22, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/27316857/stroke-care-programme-in-aragon-paia-strategy-and-outcomes-for-the-period-2009-2014
#17
J Marta Moreno, M Bestué Cardiel, A Giménez Muñoz, M Palacín Larroy
INTRODUCTION: In 2008, stroke mortality, morbidity, and disability rates in Aragon were higher than the average in Spain. These data underscored the need to develop a stroke care programme (PAIA). MATERIAL AND METHODS: We present the dynamics of planning, implementation, evaluation, and improvement developed between 2009 and 2014 as well as the results of the PAIA after that 5-year period. RESULTS: Structure, processes, and outcomes have improved with reference to the key indicators of healthcare (audit: 2008, 2010, 2012) among others: stroke rate in 2013 was 2...
June 14, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/27311003/simulation-training-for-emergency-teams-to-manage-acute-ischemic-stroke-by-telemedicine
#18
Sébastien Richard, Gioia Mione, Claude Varoqui, Arnaud Vezain, Arielle Brunner, Serge Bracard, Marc Debouverie, Marc Braun
Telemedicine contributes to initiating early intravenous recombinant tissue plasminogen activator (rt-PA) treatment for patients with acute cerebral infarction in areas without a stroke unit. However, the experience and skills of the emergency teams in the spokes to prepare patients and administer rt-PA treatment are ill-defined. Improving these skills could vastly improve management of acute stroke by telemedicine. We developed a medical simulation training model for emergency teams to perform intravenous rt-PA treatment in a telestroke system...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27296797/-a-comparison-of-remote-and-bedside-assessment-of-the-nih-stroke-scale-in-acute-stroke-patients
#19
A M Alasheev, A Yu Andreev, Yu V Gonysheva, M N Lagutenko, G I Lipin, E E Lokteva, O Yu Lutskovich, A V Mamonova, E V Prazdnichkova, A A Belkin
AIM: Telestroke videoconference for conducting the National Institute of Health Stroke Scale (NIHSS) is recommended when 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 subjectivity of NIHSS administration. Authors aimed to evaluate NIHSS telestroke assessment, while implementing measures to minimize subjectivity bias. MATERIAL AND METHODS: Ninety acute stroke patients within 48 hours of onset were assessed by 6 stroke neurologists grouped in 15 pairs...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27281534/a-low-cost-tablet-based-option-for-prehospital-neurologic-assessment-the-itreat-study
#20
Sherita N Chapman Smith, Prasanthi Govindarajan, Matthew M Padrick, Jason M Lippman, Timothy L McMurry, Brian L Resler, Kevin Keenan, Brian S Gunnell, Prachi Mehndiratta, Christina Y Chee, Elizabeth A Cahill, Cameron Dietiker, David C Cattell-Gordon, Wade S Smith, Debra G Perina, Nina J Solenski, Bradford B Worrall, Andrew M Southerland
OBJECTIVES: In this 2-center study, we assessed the technical feasibility and reliability of a low cost, tablet-based mobile telestroke option for ambulance transport and hypothesized that the NIH Stroke Scale (NIHSS) could be performed with similar reliability between remote and bedside examinations. METHODS: We piloted our mobile telemedicine system in 2 geographic regions, central Virginia and the San Francisco Bay Area, utilizing commercial cellular networks for videoconferencing transmission...
July 5, 2016: Neurology
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