A Novel Use of Prehospital Telemedicine to Decrease Door to Computed Tomography Results in Acute Strokes

Area of Science:

• Emergency medicine
• Neurology
• Telehealth

Background:

• Timely emergency department (ED) recognition of acute strokes is crucial for reducing patient morbidity and mortality.
• Prehospital telehealth evaluations can expedite patient assessment and resource mobilization before ED arrival.

Purpose of the Study:

• To evaluate the impact of prehospital telehealth evaluations on ED computed tomography (CT) acquisition and thrombolytic decision-making times for acute stroke patients.

Main Methods:

• Seventeen ambulances were equipped for remote video examinations by ED physicians.
• Paramedics used the Cincinnati Stroke Scale and NIH Stroke Scale for prehospital stroke assessment.
• Patients with positive stroke assessments were directly routed for CT scans upon ED arrival.

Main Results:

• Significant improvements were observed in all measured time intervals.
• Time from ED arrival to CT result decreased by an average of 5.6 minutes.
• Time from ED arrival to CT order decreased by 1.7 minutes, and time from CT order to result decreased by 3.89 minutes.

Conclusions:

• Prehospital telehealth consultations for acute stroke patients significantly decrease critical time intervals.
• This approach streamlines the process from emergency medical service (EMS) to CT results, facilitating faster eligibility determination for thrombolytic therapy.