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Telestroke

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https://www.readbyqxmd.com/read/29345529/effects-of-telestroke-on-thrombolysis-times-and-outcomes-a-meta-analysis
#1
Alireza Baratloo, Leila Rahimpour, Abdelrahman Ibrahim Abushouk, Saeed Safari, Chung Wing Lee, Ali Abdalvand
OBJECTIVE: Telestroke systems are tools, used to provide an advanced stroke care in regions without sufficient neurologic services. We performed this meta-analysis to assess the effects of telemedicine on treatment times and clinical outcomes of acute stroke care. METHODS: A literature search of PubMed, SCOPUS, and Cochrane CENTRAL was conducted for original studies investigating telemedicine applications in acute stroke care. Dichotomous data on treatment outcomes were pooled as odds ratios (ORs), while continuous data on thrombolysis times were pooled as mean differences (MDs) with 95% confidence interval (CI), using RevMan software (version 5...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29250111/ruling-out-brain-ct-contraindications-prior-to-intravenous-thrombolysis-diagnostic-equivalence-between-a-primary-interpretation-workstation-and-a-mobile-tablet-computer
#2
Antonio J Salazar, Nicolás Useche, Manuel Granja, Aníbal J Morillo, Sonia Bermúdez
Objective: The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. Materials and Methods: The ethics committee of our institution approved this retrospective study. A factorial design with 1452 interpretations was used. The assessed variables were the type of stroke classification, the presence of contraindications to the tPA administration, the presence of a hyperdense intracranial artery sign (HMCA), and the Alberta Stroke Program Early CT Score (ASPECTS) score...
2017: International Journal of Telemedicine and Applications
https://www.readbyqxmd.com/read/29247142/novel-telestroke-program-improves-thrombolysis-for-acute-stroke-across-21-hospitals-of-an-integrated-healthcare-system
#3
Mai N Nguyen-Huynh, Jeffrey G Klingman, Andrew L Avins, Vivek A Rao, Abigail Eaton, Sunil Bhopale, Anne C Kim, John W Morehouse, Alexander C Flint
BACKGROUND AND PURPOSE: Faster treatment with intravenous alteplase in acute ischemic stroke is associated with better outcomes. Starting in 2015, Kaiser Permanente Northern California redesigned its acute stroke workflow across all 21 Kaiser Permanente Northern California stroke centers to (1) follow a single standardized version of a modified Helsinki model and (2) have all emergency stroke cases managed by a dedicated telestroke neurologist. We examined the effect of Kaiser Permanente Northern California's Stroke EXpediting the PRrocess of Evaluating and Stopping Stroke program on door-to-needle (DTN) time, alteplase use, and symptomatic intracranial hemorrhage rates...
December 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29209268/implementation-and-evaluation-of-an-economic-model-for-telestroke-experience-from-virtuall-france
#4
Nolwenn Riou-Comte, Gioia Mione, Lisa Humbertjean, Arielle Brunner, Arnaud Vezain, Karine Lavandier, Sophie Marchal, Serge Bracard, Marc Debouverie, Sébastien Richard
Background: Telestroke is recognized as a safe and time-efficient way of treating stroke patients. However, admission centers (spokes) are subject to financial charges which can make them reluctant to join the system. We implemented and assessed an economic model supporting our telestroke system, Virtuall, France, which includes one expert center (hub) and six spokes. Methods: The model is based on payment for the expertise provided by the hub, distribution of charges related to telemedicine according to the fees perceived by the spokes, and transfer of patients between the spokes and the hub...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29205017/drip-and-ship-stroke-thrombolysis-in-the-emergency-department-of-a-healthcare-center-a-possibility-for-those-fallen-ill-in-rural-settings
#5
Joonas H Kauppila, Lasse Raatiniemi, Juha-Matti Isokangas, Matti Martikainen, Katja Piironen
Thrombolysis with tissue plasminogen activator is the mainstay in the treatment of acute stroke. Reducing the delay of thrombolysis treatment improves patient prognosis and reduces the incidence of complications. Variable telestroke regimens have improved the availability of stroke thrombolysis, especially in rural settings, where neurologists are not readily available. In the drip-and-ship strategy, stroke thrombolysis is initiated in a peripheral hospital and the patient is then transferred to a tertiary care unit...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29198965/telestroke-india-s-solution-to-a-public-health-care-crisis
#6
Jacquelyn Corley
No abstract text is available yet for this article.
November 29, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29157233/integrating-acute-stroke-telemedicine-consultations-into-specialists-usual-practice-a-qualitative-analysis-comparing-the-experience-of-australia-and-the-united-kingdom
#7
Kathleen L Bagot, Dominique A Cadilhac, Christopher F Bladin, Caroline L Watkins, Michelle Vu, Geoffrey A Donnan, Helen M Dewey, Hedley C A Emsley, D Paul Davies, Elaine Day, Gary A Ford, Christopher I Price, Carl R May, Alison S R McLoughlin, Josephine M E Gibson, Catherine E Lightbody
BACKGROUND: Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. METHODS: Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012)...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29132637/coding-acute-stroke-care-and-telestroke-with-the-international-classification-of-health-interventions-ichi
#8
Robin Ohannessian, Nicola Fortune, Jean-Marie Rodrigues, Thierry Moulin, Laurent Derex, Richard Madden, Anne-Marie Schott
BACKGROUND: and purpose: Acute stroke care is to detect, diagnose, and treat patients in the shortest amount of time. Access to acute stroke care may however be limited in some areas and telemedicine has been thus used to increase its access. Coding acute stroke care as a health intervention had limited attention in the past. METHODS: The International Classification of Health Interventions (ICHI) currently under development was used to identify existing codes relevant for coding acute stroke care interventions, including telestroke...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28989806/the-progress-of-telestroke-in-china
#9
REVIEW
Gang Zhao, Huan Huang, Fang Yang
Stroke remains the leading cause of death in China. The disparity of distribution in specialists and hospitals affects access to timely stroke care. Telestroke, the use of telemedicine for stroke, may be the solution to access to stroke care. Telestroke can improve the rate of successful intravenous thrombolysis and shorten the time to treatment. Here we review the progress of telestroke in China.
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28974997/the-door-to-needle-time-metric-can-be-achieved-via-telestroke
#10
Ganesh Asaithambi, Amy L Castle, Michael A Sperl, Jayashree Ravichandran, Aditi Gupta, Bridget M Ho, Sandra K Hanson
The administration of intravenous (IV) alteplase to patients with stroke via telestroke (TS) can be safe and effective. It remains unclear how quickly IV alteplase occurs during TS evaluations. We sought to compare door to needle times (DNTs) between patients receiving IV alteplase who present directly to our comprehensive stroke center (CSC) and those presenting to community hospitals in our TS network. Consecutive patients with acute ischemic stroke (AIS) who presented to emergency departments and received IV alteplase between August 2014 and June 2015 were identified at our CSC and TS network...
October 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28913684/-telemedicine-in-stroke-care
#11
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...
November 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28877562/rate-of-stroke-mimics-over-telestroke
#12
Dong In Sinn, Sami Al Kasab, Chirantan Banerjee, Shelly Ozark
No abstract text is available yet for this article.
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28870567/tele-neurology-in-sub-saharan-africa-a-systematic-review-of-the-literature
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
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...
September 2017: Journal of the American Geriatrics Society
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