+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prehospital utility of rapid stroke evaluation using in-ambulance telemedicine: a pilot feasibility study



Prehospital utility of rapid stroke evaluation using in-ambulance telemedicine: a pilot feasibility study



Stroke 45(8): 2342-2347



Prehospital evaluation using telemedicine may accelerate acute stroke treatment with tissue-type plasminogen activator. We explored the feasibility and reliability of using telemedicine in the field and ambulance to help evaluate acute stroke patients. Ten unique, scripted stroke scenarios, each conducted 4 times, were portrayed by trained actors retrieved and transported by Houston Fire Department emergency medical technicians to our stroke center. The vascular neurologists performed remote assessments in real time, obtaining clinical data points and National Institutes of Health (NIH) Stroke Scale, using the In-Touch RP-Xpress telemedicine device. Each scripted scenario was recorded for a subsequent evaluation by a second blinded vascular neurologist. Study feasibility was defined by the ability to conduct 80% of the sessions without major technological limitations. Reliability of video interpretation was defined by a 90% concordance between the data derived during the real-time sessions and those from the scripted scenarios. In 34 of 40 (85%) scenarios, the teleconsultation was conducted without major technical complication. The absolute agreement for intraclass correlation was 0.997 (95% confidence interval, 0.992-0.999) for the NIH Stroke Scale obtained during the real-time sessions and 0.993 (95% confidence interval, 0.975-0.999) for the recorded sessions. Inter-rater agreement using κ-statistics showed that for live-raters, 10 of 15 items on the NIH Stroke Scale showed excellent agreement and 5 of 15 showed moderate agreement. Matching of real-time assessments occurred for 88% (30/34) of NIH Stroke Scale scores by ±2 points and 96% of the clinical information. Mobile telemedicine is reliable and feasible in assessing actors simulating acute stroke in the prehospital setting.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055120595

Download citation: RISBibTeXText

PMID: 24938842

DOI: 10.1161/strokeaha.114.005193


Related references

Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project. Cerebrovascular Diseases 42(1-2): 15-22, 2017

Ambulance-based assessment of NIH Stroke Scale with telemedicine: A feasibility pilot study. Journal of Telemedicine and Telecare 23(4): 476-483, 2016

Technical feasibility and ambulance nurses' view of a digital telemedicine system in pre-hospital stroke care - A pilot study. International Emergency Nursing 2019, 2019

Feasibility of AmbulanCe-Based Telemedicine (FACT) study: safety, feasibility and reliability of third generation in-ambulance telemedicine. Plos One 9(10): E110043, 2015

Prehospital unassisted assessment of stroke severity using telemedicine: a feasibility study. Stroke 44(10): 2907-2909, 2013

Telemedicine in Prehospital Stroke Evaluation and Thrombolysis: Taking Stroke Treatment to the Doorstep. JAMA Neurology 73(2): 162-168, 2016

PreHospital Ambulance Stroke Test - pilot study of a novel stroke test. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 25(1): 37, 2017

Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study. BMJ Open 7(9): E017340, 2018

Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824). Stroke Research and Treatment 2012: 385753, 2012

Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study. Stroke 43(8): 2086-2090, 2012

Feasibility of prehospital teleconsultation in acute stroke--a pilot study in clinical routine. Plos One 7(5): E36796, 2012

Rethinking Prehospital Stroke Notification: Assessing Utility of Emergency Medical Services Impression and Cincinnati Prehospital Stroke Scale. Journal of Stroke and Cerebrovascular Diseases 27(4): 919-925, 2017

Telemedicine stroke department network. Introduction of a telemedicine pilot project for integrated stroke management in South Bavaria and analysis of its efficiency. Der Nervenarzt 75(2): 161-165, 2004

The ACUTE (Ambulance CPAP: Use, Treatment effect and economics) feasibility study: a pilot randomised controlled trial of prehospital CPAP for acute respiratory failure. Pilot and Feasibility Studies 4: 86, 2018

Improved prehospital triage of patients with stroke in a specialized stroke ambulance: results of the pre-hospital acute neurological therapy and optimization of medical care in stroke study. Stroke 46(3): 740-745, 2015