Stroke thrombolysis given by emergency physicians: The time is here.

Area of Science:

• Neurology
• Emergency Medicine
• Healthcare Management

Background:

• Neurologist shortages impact acute stroke care, with projected deficits worldwide.
• Emergency medicine providers often rely on neurology consultations for stroke treatment.
• Existing teleneurology models primarily involve neurologists.

Purpose of the Study:

• To evaluate a novel model where Emergency Medicine Stroke Champions provide direct stroke care and teleneurology consultation.
• To assess the feasibility and safety of emergency physician-led telestroke services.
• To improve treatment accessibility for acute ischemic stroke (AIS) patients.

Main Methods:

• Implementation of an Emergency Medicine Stroke Champion (SC) program at a hub and spoke hospital system.
• SCs independently administered fibrinolytic therapy and provided teleneurology consultations.
• Data collected over nineteen months on stroke alerts, treatments, and consultations.

Main Results:

• SCs managed 457 stroke alerts, with 16 patients receiving IV alteplase.
• A low rate of hemorrhagic conversion (6.25%) was observed.
• SCs facilitated 64 patient transfers and provided teleneurology support to other emergency physicians.

Conclusions:

• Emergency physician Stroke Champions can safely and effectively manage acute stroke patients.
• This model demonstrates the feasibility of emergency physician-led teleneurology for stroke care.
• The program has the potential to be generalized to enhance emergency stroke management nationwide.