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Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service

BACKGROUND: The majority of established telestroke services are based on “hub‐and‐spoke” models for providing acute clinical assessment and thrombolysis. We report results from the first year of the successful implementation of a locally based telemedicine network, without the need of 1 or more hub...

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Autores principales: Agarwal, Smriti, Day, Diana J., Sibson, Lynda, Barry, Patrick J., Collas, David, Metcalf, Kneale, Cotter, Paul E., Guyler, Paul, O'Brien, Eoin W., O'Brien, Anthony, O'Kane, Declan, Owusu‐Agyei, Peter, Phillips, Peter, Shekhar, Raj, Warburton, Elizabeth A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959696/
https://www.ncbi.nlm.nih.gov/pubmed/24572251
http://dx.doi.org/10.1161/JAHA.113.000408
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author Agarwal, Smriti
Day, Diana J.
Sibson, Lynda
Barry, Patrick J.
Collas, David
Metcalf, Kneale
Cotter, Paul E.
Guyler, Paul
O'Brien, Eoin W.
O'Brien, Anthony
O'Kane, Declan
Owusu‐Agyei, Peter
Phillips, Peter
Shekhar, Raj
Warburton, Elizabeth A.
author_facet Agarwal, Smriti
Day, Diana J.
Sibson, Lynda
Barry, Patrick J.
Collas, David
Metcalf, Kneale
Cotter, Paul E.
Guyler, Paul
O'Brien, Eoin W.
O'Brien, Anthony
O'Kane, Declan
Owusu‐Agyei, Peter
Phillips, Peter
Shekhar, Raj
Warburton, Elizabeth A.
author_sort Agarwal, Smriti
collection PubMed
description BACKGROUND: The majority of established telestroke services are based on “hub‐and‐spoke” models for providing acute clinical assessment and thrombolysis. We report results from the first year of the successful implementation of a locally based telemedicine network, without the need of 1 or more hub hospitals, across a largely rural landscape. METHODS AND RESULTS: Following a successful pilot phase that demonstrated safety and feasibility, the East of England telestroke project was rolled out across 7 regional hospitals, covering an area of 7500 square miles and a population of 5.6 million to enable out‐of‐hours access to thrombolysis. Between November 2010 and November 2011, 142 telemedicine consultations were recorded out‐of‐hours. Seventy‐four (52.11%) cases received thrombolysis. Median (IQR) onset‐to‐needle and door‐to‐needle times were 169 (141.5 to 201.5) minutes and 94 (72 to 113.5) minutes, respectively. Symptomatic hemorrhage rate was 7.3% and stroke mimic rate was 10.6%. CONCLUSIONS: We demonstrate the safety and effectiveness of a horizontal networking approach for stroke telemedicine, which may be applicable to areas where traditional “hub‐and‐spoke” models may not be geographically feasible.
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spelling pubmed-39596962014-03-20 Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service Agarwal, Smriti Day, Diana J. Sibson, Lynda Barry, Patrick J. Collas, David Metcalf, Kneale Cotter, Paul E. Guyler, Paul O'Brien, Eoin W. O'Brien, Anthony O'Kane, Declan Owusu‐Agyei, Peter Phillips, Peter Shekhar, Raj Warburton, Elizabeth A. J Am Heart Assoc Original Research BACKGROUND: The majority of established telestroke services are based on “hub‐and‐spoke” models for providing acute clinical assessment and thrombolysis. We report results from the first year of the successful implementation of a locally based telemedicine network, without the need of 1 or more hub hospitals, across a largely rural landscape. METHODS AND RESULTS: Following a successful pilot phase that demonstrated safety and feasibility, the East of England telestroke project was rolled out across 7 regional hospitals, covering an area of 7500 square miles and a population of 5.6 million to enable out‐of‐hours access to thrombolysis. Between November 2010 and November 2011, 142 telemedicine consultations were recorded out‐of‐hours. Seventy‐four (52.11%) cases received thrombolysis. Median (IQR) onset‐to‐needle and door‐to‐needle times were 169 (141.5 to 201.5) minutes and 94 (72 to 113.5) minutes, respectively. Symptomatic hemorrhage rate was 7.3% and stroke mimic rate was 10.6%. CONCLUSIONS: We demonstrate the safety and effectiveness of a horizontal networking approach for stroke telemedicine, which may be applicable to areas where traditional “hub‐and‐spoke” models may not be geographically feasible. Blackwell Publishing Ltd 2014-02-28 /pmc/articles/PMC3959696/ /pubmed/24572251 http://dx.doi.org/10.1161/JAHA.113.000408 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Agarwal, Smriti
Day, Diana J.
Sibson, Lynda
Barry, Patrick J.
Collas, David
Metcalf, Kneale
Cotter, Paul E.
Guyler, Paul
O'Brien, Eoin W.
O'Brien, Anthony
O'Kane, Declan
Owusu‐Agyei, Peter
Phillips, Peter
Shekhar, Raj
Warburton, Elizabeth A.
Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title_full Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title_fullStr Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title_full_unstemmed Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title_short Thrombolysis Delivery by a Regional Telestroke Network—Experience From the UK National Health Service
title_sort thrombolysis delivery by a regional telestroke network—experience from the uk national health service
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959696/
https://www.ncbi.nlm.nih.gov/pubmed/24572251
http://dx.doi.org/10.1161/JAHA.113.000408
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