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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
February 7, 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
#11
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
#12
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
https://www.readbyqxmd.com/read/27992822/thrombolytic-treatment-to-stroke-mimic-patients-via-telestroke
#13
Ganesh Asaithambi, Amy L Castle, Michael A Sperl, Jayashree Ravichandran, Aditi Gupta, Bridget M Ho, Sandra K Hanson
OBJECTIVE: The safety and outcomes of intravenous thrombolysis (IVT) to stroke patients via telestroke (TS) is similar to those presenting to stroke centers. Little is known on the accuracy of TS diagnosis among those receiving IVT. We sought to compare the rate of patients receiving IVT with diagnosis of ischemic stroke as opposed to stroke mimic (SM) in our TS network to those who presented to our comprehensive stroke center (CSC). MATERIALS AND METHODS: Consecutive patients receiving IVT between August 2014 and June 2015 were identified at our CSC and TS network...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27899742/acute-endovascular-treatment-delivery-to-ischemic-stroke-patients-transferred-within-a-telestroke-network-a-retrospective-observational-study
#14
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
#15
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...
March 2017: 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
#16
COMPARATIVE STUDY
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...
December 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
#17
REVIEW
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...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27805298/telestroke-imaging-a-review
#18
REVIEW
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...
January 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27782019/whatsapp-in-clinical-practice-a-literature-review
#19
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
#20
Maya Madhavan, Steven Karceski
No abstract text is available yet for this article.
September 27, 2016: Neurology
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