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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Telestroke Consultation in the Emergency Medical Services Unit: A Novel Approach to Improve Thrombolysis Times
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Telestroke Consultation in the Emergency Medical Services Unit: A Novel Approach to Improve Thrombolysis Times

机译：Telestroke在紧急医疗服务单位咨询：一种改善溶栓次数的新方法

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Background: Faster treatment times are associated with improved outcomes in patients with acute ischemic stroke. In this prospective pilot study, we assess the feasibility of initiating telestroke consultation in emergency medical services unit (TEMS). Methods: Patients with stroke symptoms were evaluated via TEMS using a video-call with a stroke provider. After TEMS evaluation, patients were transferred to the nearest stroke center (NSC) or thrombectomy capable center (TCS) depending on stroke severity and symptom onset time. We compared time metrics between patients evaluated via TEMS to those via standard telestroke (STS) consultation. Results: 49 patients were evaluated via TEMS between May 2017 and March 2020. Median age was 66, 24 (49%) were females, 15 (30.6%) received intravenous alteplase (tPA) after arrival to a local hospital, and 3 (6.1%) underwent mechanical thrombectomy (MT) after bypassing the NSC. Compared to 52 tPA patients treated through STS consultation, TEMS patients had shorter door to needle (DTN) time (21 vs. 38 min, p < 0.001). In addition, patients who received MT after bypassing the NSC had shorter onset to groin time compared to those transferred from NSC (216 vs. 293 min, P = 0.04). Conclusion: Prehospital stroke triaging using TEMS is feasible, and could result in shorter DTN and onset to groin times.
机译：背景：更快的治疗时间与急性缺血性卒中患者的预后改善相关。在这项前瞻性试点研究中，我们评估了在急诊医疗服务部（TEMS）开展远程中风会诊的可行性。方法：通过TEMS，通过与中风提供者的视频通话，对有中风症状的患者进行评估。在TEMS评估后，根据卒中严重程度和症状出现时间，患者被转移到最近的卒中中心（NSC）或血栓切除中心（TCS）。我们比较了通过TEMS评估的患者与通过标准远程中风（STS）咨询评估的患者之间的时间指标。结果：2017年5月至2020年3月，49名患者通过TEMS进行了评估。中位年龄为66岁，24（49%）为女性，15（30.6%）在抵达当地医院后接受静脉注射阿替普酶（tPA），3（6.1%）在绕过NSC后接受机械血栓切除术（MT）。与经STS会诊治疗的52名tPA患者相比，TEMS患者的门到针（DTN）时间更短（分别为21分钟和38分钟，p<0.001）。此外，与从NSC转移到腹股沟的患者相比，绕过NSC后接受MT的患者从腹股沟到腹股沟的起病时间更短（216对293分钟，P=0.04）。结论：使用TEMS进行院前卒中分型是可行的，可以缩短DTN和腹股沟起病时间。

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