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Electroconvulsive Therapy01:30

Electroconvulsive Therapy

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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  1. Home
  3. Telestroke Consultant Use In Acute Stroke Care: Evidence For Best Practices From The Improve Stroke Care Program.
  1. Home
  3. Telestroke Consultant Use In Acute Stroke Care: Evidence For Best Practices From The Improve Stroke Care Program.

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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Telestroke consultant use in acute stroke care: Evidence for best practices from the IMPROVE stroke care program.

Brad J Kolls1,2, Edwin Iversen3, Lisa Monk2

  • 1Department of Neurology, Duke University School of Medicine, Durham, NC, USA.

Journal of Telemedicine and Telecare
|April 21, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Optimizing telestroke care involves rapid code stroke activation and notifying consultants before CT scans. Prehospital notification by EMS significantly improves door-to-needle times for stroke patients.

Keywords:
Telestrokeacute stroke managementbest practicesstroke care systemstelehealth

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Area of Science:

  • Neurology
  • Healthcare Management
  • Telemedicine

Background:

  • Evolving stroke care necessitates efficient patient screening and timely specialist intervention.
  • Telestroke services are increasingly vital for improving access to stroke expertise.
  • This study examines telestroke care processes to identify optimal workflows.

Purpose of the Study:

  • To determine optimal care processes for timely acute stroke treatment using telestroke.
  • To identify key steps associated with improved thrombolytic administration times.

Main Methods:

  • Post-hoc analysis of data from the IMPROVE stroke care quality improvement program.
  • Normalized door-to-needle (DTN) times using linear mixed models.
  • Assessed associations between care process steps and DTN improvements.

Main Results:

  • 80.6% of 21,456 acute stroke assessments utilized telestroke (TS) services.
  • EMS arrival improved DTN ranks by 4%; prehospital notification with EMS improved DTN by 25%.
  • Rapid code stroke activation and pre-CT consultant notification were key to shorter DTN times.

Conclusions:

  • Prehospital notification by Emergency Medical Services (EMS) is crucial for timely stroke care.
  • Rapid code stroke activation and early telestroke consultant notification are best practices.
  • Optimized telestroke workflows enhance acute stroke treatment delivery.