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2 results

  • Application of Telemedicine in the Ambulance for Stroke Patients: A Systematic Review

  • Fatemeh Sarpourian, Milad Ahmadi Marzaleh, Seyed Ali Fatemi Aghda, Zahra Zare
  • Journal:
    Prehospital and Disaster Medicine / Volume 38 / Issue 6 / December 2023
    Published online by Cambridge University Press:
    25 October 2023, pp. 774-779
    Print publication:
    December 2023
  • Introduction:

    The use of telemedicine for the prehospital management of emergency conditions, especially stroke, is increasing day by day. Few studies have investigated the applications of telemedicine in Emergency Medical Services (EMS). A comprehensive study of the applications of this technology in stroke patients in ambulances can help to build a better understanding. Therefore, this systematic review was conducted to investigate the use of telemedicine in ambulances for stroke patients in 2023.

    Methods:

    A systematic search was conducted in PubMed, Cochrane, Scopus, ProQuest, Science Direct, and Web of Science from 2013 through March 1, 2023. The authors selected the articles based on keywords and criteria and reviewed them in terms of title, abstract, and full text. Finally, the articles that were related to the study aim were evaluated.

    Results:

    The initial search resulted in the extraction of 2,795 articles. After review of the articles, and applying the inclusion and exclusion criteria, seven articles were selected for the final analysis. Three (42.85%) studies were on the feasibility and intervention types. Also, randomized trials, feasibility, feasibility and prospective-observational, and feasibility and retrospective-interventional studies were each one (14.28%). Six (85.71%) of the studies were conducted in the United States. The National Institutes of Health Stroke Scale (NIHSS) and RP-Xpress were the most commonly used tools for neurological evaluations and teleconsultations.

    Conclusion:

    Remote prehospital consultations, triage, and sending patient data before they go to the emergency department can be provided through telemedicine in ambulances. Neurological evaluations via telemedicine are reliable and accurate, and they are almost equal to in-person evaluations by a neurologist.

  • Chapter 9 - Spinal cord disease in the hospitalized patient

  • Edited by S. Andrew Josephson, University of California, San Francisco, W. David Freeman, David J. Likosky
  • Book:
    Neurohospitalist Medicine
    Published online:
    07 October 2011
    Print publication:
    29 September 2011, pp 127-141

  • Summary

    Acute ischemic stroke is a medical emergency. The initial evaluation of the potential stroke patient often occurs in a high-acuity area. Medical personnel responsible for establishing intravenous access, initiating cardiorespiratory monitoring, performing blood draws, and performing electrocardiography compete for the patient's attention. Additionally, the presence of aphasia or neglect may limit the patient's ability to provide accurate information. The neurological examination should focus on identifying signs of lateralized hemispheric or brainstem dysfunction consistent with stroke. The National Institutes of Health Stroke Scale (NIHSS) is a validated scale that has gained widespread acceptance as a standard clinical assessment tool. The chapter discusses evidence-based ischemic stroke treatment strategies. Determination of stroke mechanism and prompt initiation of secondary stroke preventative strategies such as anti-thrombotic therapy, aggressive risk-factor management, and carotid revascularization in carefully selected patients provide an opportunity to reduce the future burden of stroke.