In-Transit Telemedicine Speeds Ischemic Stroke Treatment: Preliminary Results

Gary H. Belt, Robert A. Felberg, Jane Rubin, John Halperin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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. We prospectively assessed door-to-needle and last-known-well-to-needle times for all intravenous alteplase-treated stroke patients brought to our emergency departments by emergency medical services' transport, comparing those with and without in-transit telestroke. Results - From January 2015 through March 2016, 111 stroke patients received intravenous alteplase at study emergency departments. Mean door to needle was 13 minutes less with in-transit telestroke (28 versus 41; P=0.02). Although limitations in cellular communication degraded transmission quality, this did not prevent the completion of satisfactory patient evaluations. Conclusions - Improvement in time to treat seems comparable with in-transit telestroke and mobile stroke transport units. The low cost/unit makes this approach scalable, potentially providing rapid management of more patients.

Original languageEnglish (US)
Pages (from-to)2413-2415
Number of pages3
JournalStroke
Volume47
Issue number9
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

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Telemedicine
Stroke
Needles
Hospital Emergency Service
Tissue Plasminogen Activator
Therapeutics
Costs and Cost Analysis
Allied Health Personnel
Ambulances
Emergency Medical Services
History
Communication
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Belt, Gary H. ; Felberg, Robert A. ; Rubin, Jane ; Halperin, John. / In-Transit Telemedicine Speeds Ischemic Stroke Treatment : Preliminary Results. In: Stroke. 2016 ; Vol. 47, No. 9. pp. 2413-2415.
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In-Transit Telemedicine Speeds Ischemic Stroke Treatment : Preliminary Results. / Belt, Gary H.; Felberg, Robert A.; Rubin, Jane; Halperin, John.

In: Stroke, Vol. 47, No. 9, 01.09.2016, p. 2413-2415.

Research output: Contribution to journalArticle

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AU - Felberg, Robert A.

AU - Rubin, Jane

AU - Halperin, John

PY - 2016/9/1

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AB - 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. We prospectively assessed door-to-needle and last-known-well-to-needle times for all intravenous alteplase-treated stroke patients brought to our emergency departments by emergency medical services' transport, comparing those with and without in-transit telestroke. Results - From January 2015 through March 2016, 111 stroke patients received intravenous alteplase at study emergency departments. Mean door to needle was 13 minutes less with in-transit telestroke (28 versus 41; P=0.02). Although limitations in cellular communication degraded transmission quality, this did not prevent the completion of satisfactory patient evaluations. Conclusions - Improvement in time to treat seems comparable with in-transit telestroke and mobile stroke transport units. The low cost/unit makes this approach scalable, potentially providing rapid management of more patients.

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