Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization
Abstract Background The reduction of processing times in the treatment of acute ischemic stroke is of outstanding importance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for det...
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BMC
2024-11-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-024-01142-3 |
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| author | Daniel Weiss Christian Rubbert Marius Kaschner Gregory Gordon Greiner Nadja Kairies-Schwarz Markus Vomhof Andrea Icks Linea Weitz Hanna Hollenberg Robin Jansen Til Menge Rüdiger J. Seitz Sebastian Jander Michael Bernhard John-Ih Lee Tobias Ruck Sven Guenther Meuth Bernd Turowski Julian Caspers Michael Gliem |
| author_facet | Daniel Weiss Christian Rubbert Marius Kaschner Gregory Gordon Greiner Nadja Kairies-Schwarz Markus Vomhof Andrea Icks Linea Weitz Hanna Hollenberg Robin Jansen Til Menge Rüdiger J. Seitz Sebastian Jander Michael Bernhard John-Ih Lee Tobias Ruck Sven Guenther Meuth Bernd Turowski Julian Caspers Michael Gliem |
| author_sort | Daniel Weiss |
| collection | DOAJ |
| description | Abstract Background The reduction of processing times in the treatment of acute ischemic stroke is of outstanding importance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for detected treatment delays. Methods We conducted an in-depth analysis of acute stroke care processing times across three local stroke centers in Düsseldorf among all emergency services transportations for suspected stroke. Isochrone mapping was performed to identify areas with prolonged transportation times. Results Among the 1,714 transportations, 943 patients had confirmed strokes. Prehospital care constituted 58% of total emergency care time until imaging. Patients with confirmed stroke had reduced in-hospital times while patients receiving treatment experienced faster in-hospital times. Isochrone mapping revealed disparities in transportation times within the city. Conclusions In conclusion, we identified confirmation of stroke symptoms as pre- and in-hospital and treatment eligibility as in-hospital process accelerators in stroke care. We propose the introduction of an in-ambulance video consulting model to accelerate contact to stroke-experts and accelerate processing times for patients eligible for treatment. Furthermore, we discuss the combination of in-ambulance video consulting with imaging and starting treatment outside traditional stroke centers, followed by transportation to a stroke center during thrombolysis, which might further accelerate treatment in specific cases. |
| format | Article |
| id | doaj-art-8ecb164eda294266bcbdbd634e1aa78c |
| institution | Kabale University |
| issn | 1471-227X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj-art-8ecb164eda294266bcbdbd634e1aa78c2024-12-01T12:13:00ZengBMCBMC Emergency Medicine1471-227X2024-11-0124111010.1186/s12873-024-01142-3Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualizationDaniel Weiss0Christian Rubbert1Marius Kaschner2Gregory Gordon Greiner3Nadja Kairies-Schwarz4Markus Vomhof5Andrea Icks6Linea Weitz7Hanna Hollenberg8Robin Jansen9Til Menge10Rüdiger J. Seitz11Sebastian Jander12Michael Bernhard13John-Ih Lee14Tobias Ruck15Sven Guenther Meuth16Bernd Turowski17Julian Caspers18Michael Gliem19Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfInstitute for Health Services Research and HEs, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfInstitute for Health Services Research and HEs, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfInstitute for Health Services Research and HEs, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfInstitute for Health Services Research and HEs, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich-Heine-University Düsseldorf, Medical FacultyDepartment of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich-Heine-University Düsseldorf, Medical FacultyDepartment of Neurology, MarienhospitalEmergency Department, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University DüsseldorfAbstract Background The reduction of processing times in the treatment of acute ischemic stroke is of outstanding importance. Our objective is to analyze the acute stroke care chain from onset to treatment in a city in Germany comprising three stroke units. Additionally, we discuss solutions for detected treatment delays. Methods We conducted an in-depth analysis of acute stroke care processing times across three local stroke centers in Düsseldorf among all emergency services transportations for suspected stroke. Isochrone mapping was performed to identify areas with prolonged transportation times. Results Among the 1,714 transportations, 943 patients had confirmed strokes. Prehospital care constituted 58% of total emergency care time until imaging. Patients with confirmed stroke had reduced in-hospital times while patients receiving treatment experienced faster in-hospital times. Isochrone mapping revealed disparities in transportation times within the city. Conclusions In conclusion, we identified confirmation of stroke symptoms as pre- and in-hospital and treatment eligibility as in-hospital process accelerators in stroke care. We propose the introduction of an in-ambulance video consulting model to accelerate contact to stroke-experts and accelerate processing times for patients eligible for treatment. Furthermore, we discuss the combination of in-ambulance video consulting with imaging and starting treatment outside traditional stroke centers, followed by transportation to a stroke center during thrombolysis, which might further accelerate treatment in specific cases.https://doi.org/10.1186/s12873-024-01142-3StrokeModels of careOutcomeCost efficiency |
| spellingShingle | Daniel Weiss Christian Rubbert Marius Kaschner Gregory Gordon Greiner Nadja Kairies-Schwarz Markus Vomhof Andrea Icks Linea Weitz Hanna Hollenberg Robin Jansen Til Menge Rüdiger J. Seitz Sebastian Jander Michael Bernhard John-Ih Lee Tobias Ruck Sven Guenther Meuth Bernd Turowski Julian Caspers Michael Gliem Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization BMC Emergency Medicine Stroke Models of care Outcome Cost efficiency |
| title | Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization |
| title_full | Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization |
| title_fullStr | Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization |
| title_full_unstemmed | Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization |
| title_short | Prehospital telemedicine support for urban stroke care: Analysis of current state of care and conceptualization |
| title_sort | prehospital telemedicine support for urban stroke care analysis of current state of care and conceptualization |
| topic | Stroke Models of care Outcome Cost efficiency |
| url | https://doi.org/10.1186/s12873-024-01142-3 |
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