Alerting neurologists via telemedicine that a patient with suspected acute stroke is en route to the hospital significantly enhances the speed at which thrombolysis is administered and increases the number of patients who receive timelier, potentially lifesaving treatment, new research showed.
Prenotification allows a neurologist to"get on the screen to begin coordinating with the ED team to adequately prepare for the possibility of thrombolytic treatment," he added.McDonald said"his organization, TeleSpecialists, maintains a large detailed medical records database for emergency-related, teleneurology, and other cases. For stroke, it recommends 15 best practices" for facilities including prenotification of teleneurology.
Of 9290 patients included in the study, 731 were treated with thrombolysis at prenotification facilities and 31 were treated at facilities without prenotification . The thrombolytic treatment rate was 8.5% at prenotification facilities vs 4.8% at facilities without prenotification — a difference that was statistically significant.
Of 761 treatment cases, there was prenotification to the neurology team in 401 cases. In 360 cases, prenotification did not occur. DTN time of less than 30 minutes is increasingly used as a target."Being treated within this time frame improves outcomes and reduces length of hospital stay," said McDonald.
Prenotification, he added,"coordinates the process and eliminates unnecessary and time-consuming steps.", David L. Tirschwell, MD, Harborview Medical Center, Department of Neurology, Seattle, who co-chaired the AAN session featuring the research, said the study provides compelling evidence that teleneurologist prenotification improves DTN time.
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