Stroke, Acute
Conditions
Keywords
pre-hospital triage, Stroke, suspected, Telemedicine, telemedical triage, Door-to-treatment-time
Brief summary
This study is to investigate clinical efficacy of the pre-hospital triage of patients with suspected acute stroke by using advanced telecommunication tools with digital audio and video real-time streaming.
Detailed description
One of today's main challenges in stroke medicine is to further decrease event-to-treatment-time. On-site, pre-hospital, clinical assessment of patients with suspected acute stroke can optimize further diagnostic and treatment pathways after patient arrival at the dedicated stroke center. A telemedical approach (interactive video and audio streaming) allows time efficient pre-hospital triage, via patient evaluation by simple, pre-defined assessment measures and a standardized questionnaire. This study is to investigate clinical efficacy of the pre-hospital triage of patients with suspected acute stroke by using advanced telecommunication tools with digital audio and video real-time streaming.
Interventions
OTHERprehospital telemedical triage
Prehospital Triage of Patients with Suspected Stroke Using Onsite Mobile Telemedicine approach (interactive video and audio streaming). In patients with suspected stroke, a prehospital patient evaluation by end-to-end encrypted real-time audio- and video streaming from the pre-hospital setting to an in-hospital stroke physician, located at the University hospital of Basel, is requested and initiated (telestroke-path). The process is supervised and evaluated by an in-hospital stroke physician in real-time. Patients considered having an acute stroke will be directly transferred to cerebral imaging via CT. All other patients will follow conventional stroke path.
Sponsors
propatient Forschungsstiftung
University Hospital, Basel, Switzerland
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* suspected acute stroke as per the first judgement of the paramedics on-site
Exclusion criteria
* Patients with a known history of epilepsia or non-epileptic seizures * Patients after/while displaying an epileptic seizure * Recent head trauma * Patient with a reduced Glasgow Coma Scale or other condition not allowing Rapid Arterial oCclusion Evaluation (RACE) examination
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Door-to-treatment-time (minutes) | one point assessment at baseline | Door-to-treatment-time (minutes), assessed as door-to-needle-time and door-to-groin-puncture-time. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| National Institutes of Health Stroke Scale (NIHSS) at 24hours | one point assessment at 24hours after hospital admission | Score to quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 and 4. For each item, a score of 0 typically indicates normal function in that specific ability, while a higher score is indicative of some level of impairment. The individual scores from each item are summed in order to calculate a patient's total NIHSS score. The maximum possible score is 42, with the minimum score being a 0. |
| National Institutes of Health Stroke Scale (NIHSS) at 90 days | one point assessment at 90 days after hospital admission | Score to quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 and 4. For each item, a score of 0 typically indicates normal function in that specific ability, while a higher score is indicative of some level of impairment. The individual scores from each item are summed in order to calculate a patient's total NIHSS score. The maximum possible score is 42, with the minimum score being a 0. |
| modified Rankin Scale (mRS) at 90 days | one point assessment at 90 days after hospital admission | The modified Rankin Scale (mRS) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke. The scale runs from 0-6, running from perfect health without symptoms (= 0) to death (= 6). |
Countries
Switzerland
Contacts
Primary ContactPhilippe Lyrer, Prof. Dr. med.
Backup ContactSebastian Thilemann, Dr. med.
Outcome results
None listed