PMID: 16649650May 3, 2006Paper

Using telemedicine to facilitate thrombolytic therapy for patients with acute stroke

Joint Commission Journal on Quality and Patient Safety
John Y ChoiJames C Grotta

Abstract

Recent stroke-care requirements state that all stroke patients should be screened for intravenous recombinant tissue plasminogen activator (rt-PA) and treated, if the appropriate inclusion and exclusion criteria are met. Two community hospitals 90-130 miles east of Houston deployed telemedicine (videoteleconferencing) to provide acute stroke consultative services. DEVELOPING A TELEMEDICINE CAPACITY: According to the Brain Attack Coalition's recommendations, neurosurgical services need to be accessible within two hours. Given their incomplete neurology coverage, the remote-site hospitals identified telemedicine as the best option, with the University of Texas Health Science Center at Houston stroke team as the provider of expertise. In the 13 months preceding the telemedicine project (January 2003-March 2004), 2 (.8%) of 327 patients received rt-PA, compared with 14 (4.3%) of 328 patients during the telemedicine project (April 2004-May 2005), p < .001). Seven patients had > or = 4 points improvement in a stroke scale at 24 hours posttreatment. Three patients worsened during the 24-hour assessment. No intracerebral hemorrhages occurred. Door-to-needle median time was 85 minutes (range, 27-165 minutes). Telemedicine facilitated th...Continue Reading

References

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Citations

Apr 16, 2010·International Journal of Technology Assessment in Health Care·Tim Johansson, Claudia Wild
Jun 28, 2015·Journal of Telemedicine and Telecare·Michael J LyerlyBrendan G Carr
May 9, 2009·Stroke; a Journal of Cerebral Circulation·Lee H SchwammUNKNOWN Council on Cardiovascular Radiology and Intervention
May 9, 2009·Stroke; a Journal of Cerebral Circulation·Lee H SchwammUNKNOWN Interdisciplinary Council on Peripheral Vascular Disease
Dec 14, 2011·Current Opinion in Neurology·Peter Müller-BarnaRoman L Haberl
Feb 19, 2014·Annals of Clinical and Translational Neurology·Tzu-Ching WuBrendan G Carr
Mar 27, 2016·Neurology·Amanda L JagolinoTzu-Ching Wu
Nov 7, 2015·Stroke Research and Treatment·Karen C AlbrightBrendan G Carr
Aug 29, 2013·The Neurohospitalist·William David FreemanBart M Demaerschalk
Jan 6, 2007·Stroke; a Journal of Cerebral Circulation·Renee Lyons, Anthony G Rudd
May 26, 2010·Stroke; a Journal of Cerebral Circulation·Yulun WangPaul Vespa
Nov 10, 2010·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Khurshid KhanPatrick Crumley
Aug 27, 2015·Expert Review of Cardiovascular Therapy·Michelle P LinDavid S Liebeskind
Mar 18, 2016·Journal of Neurointerventional Surgery·F AkbikT M Leslie-Mazwi

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