22. European Stroke Conference 662 © 2013 S. Karger AG, Basel Scientific Programme 599 Acute stroke: emergency management, stroke units and complications First year experience of acute stroke Thrombolysis by Telemedicine at Medway Hospital, En-gland A. Mahmood1, M. Mamun2, S.N. Sanmuganathan3, J. Jones4 Medway NHS Foundation trust, Gillingham, UNITED KINGDOM1, Medway NHS foundation trust, Gillingham, UNITED KINGDOM2, Medway NHS foundation trust, Gillingham, UNITED KINGDOM3, Medway NHS foundation trust, Gillingham, UNITED KINGDOM4 Background Medway foundation trust hospital is a large District General Hospital (DGH) in the southeast of England and serves a population of 400,000. With three stroke physicians it was not possible to pro-vide 24/7 thrombolysis service. The same issues were being faced by the neighbouring three acute DGH (Maidstone, Tunbridge Wells and Darent Valley hospitals) with a combined population of 1.2 million. Between 2010 and 2011 a rota was used where each hospital would be on call out of hours once in four weeks. All suspected and suitable for thrombolysis stroke patients would be transported to the on-call hospital and it could involve a distance of up to 50 miles. Problems with this set up were: • Delayed treatment • Inconvenience for patients, relatives and ambulance staff. • Delayed repatriation and longer stay on acute stroke units • Difficulties in rehabilitation and community care as several authorities were involved. Telemedicine (real time, two way audio and video, digital imaging and communication) for acute stroke thrombolysis is only used in about 30 out of 168 acute trusts in the UK. Medway along with the three DGH set up a network in 2011. This has facilitated remote specialist consultation from vir-tually any location within minutes of patient contact. METHOD Retrospective study of patient notes and stroke data bank (SSNAP) RESULTS: Medway Site CONCLUSION By the introduction of Telemedicine the number of patients assessed to be eligible for Thromboly-sis has come down by 49% and this is due to earlier specialist involvement. The number of patients who actually receive treatment with rt-PA has gone up from 25% to 91% at all hours and from 33% to 91% out of hours. The door to needle time has surprisingly gone up and is probably due to local issues. Telemedicine has proven to be very beneficial for increased targeted therapy in our first year.
Karger_ESC London_2013
To see the actual publication please follow the link above