Competing Interests Declaration. Learning Objectives. Stroke treatment. < 3 Hours from onset NINDS tpa Trial Parts A and B. Acute stroke treatment
|
|
- Sabina Oliver
- 7 years ago
- Views:
Transcription
1 Telemedicine and cerebrovascular disease: The telestroke advantage in Alberta Ashfaq Shuaib MD FRCPC University of Alberta Canada Competing Interests Declaration Competing interests I chair the steering committee of the SENTIS and FastFlo trials and am an advisor to CoAxia I am on the steering committees of the DIAS 4 and MAST trials In the past 5 years, I have received speaker fees from: Sanofi-Aventis/BMS, BI, Pfizer, Merck, Roche, Servier, AstraZeneca In the past 5 years, I have served on advisory boards for: AstraZeneca, BI, Sanofi-Aventis/BMS, Roche, Pfizer Learning Objectives 1. Management issues in stroke 2. Telemedicine and its role in treatment of cerebrovascular diseases 3. Tele-stroke in Alberta Stroke treatment Organized care, especially Stroke Units, offers the best opportunity for recover after an acute stroke The most important goals of stroke treatment focus on prevention Prevention of complications Prevention of recurrent stroke It is important to recognize the important role of rehabilitation services in recovery Acute stroke treatment Stabilize patient Consider thrombolysis if the patient meets criteria less than 3% of acute stroke patients currently getting therapy Offer plan for immediate care and prevention of recurrence Recovery < 3 Hours from onset NINDS tpa Trial Parts A and B NNT= 6-8 Complete Incomplete Poor Death Placebo rt-pa Major problem: less than 5 % treated / requires a stroke program
2 < 3 Hours from onset NINDS tpa Trial age < 60 Parts A and B Placebo rt-pa n=174 NNT=4 to cure Recovery Sympt ICH 5% Complete Incomplete Poor Death Lack of timely access (out of window) Patient s lack of awareness Physical Delayed recognition Physician attitude Geographical location Lack of expertise / unwillingness
3 Why is CT essential? Hemorrhage or No hemorrhage Calcification or Hemorrhage???? Learning Objectives Teleconferencing and medicine 1. Management issues in stroke 2. Telemedicine and its role in treatment of cerebrovascular diseases 3. Tele-stroke in Alberta Cardiology Pediatrics ICU Trauma Stroke
4 Telemedicine and cerebrovascular diseases Acute stroke Prevention of stroke Lancet Neurol 2008 Learning Objectives 1. Management issues in stroke 2. Telemedicine and its role in treatment of cerebrovascular diseases 3. Tele-stroke in Alberta
5 Minimize Delay- Hospital Bypass So what do we do with this information for Rural Alberta? Small communities with hospitals at considerable distances from major tertiary centers 8 miles Local hospital No CT scanner Minimize Delay- Hospital Bypass Minimize Delay- Hospital Bypass 40 miles CT scanner 8 miles 40 miles CT scanner unavailable 8 miles Local hospital No CT scanner Local hospital No CT scanner 70 miles iv rt-pa rfviia Helical or multislice CT scanner 24h/365 d coverage Primary Stroke Center Transfer for Rescue Therapy 8 miles 40 miles CT scanner Local hospital No CT scanner 70 miles intraclot lysis ICH evacuation iv rt-pa rfviia 170 miles Early ICA revascularization Helical or multislice CT scanner 24h/365d coverage Primary Stroke Center Interventional Facilitiesinterventional neurorad, neurosurgery Comprehensive Stroke Center
6 Case #1 A 56 year old lady with hypertension experienced unusual episodes of altitudinal L eye visual loss for two weeks Then she experienced two episodes of complete visual loss in the left eye Later that day she collapsed with inability to speak and right hemiplegia She is brought to your hospital 170 km from Edmonton Case 1 What do you need to do immediately? Rapid history Assessment TIME OF ONSET (OR WHEN LAST SEEN WELL) Contra-indications to tpa Family contacts/information Rapid physical exam (ABCs first) Neuro exam quick but complete Examine heart and lungs Temp, HR, BP!! Case 1 (cont) Time windows of importance Your centre is located 2 hours transport by ground from Edmonton Will this patient be a candidate for intravenous tpa? Should the acute stroke physician be notified? 0-3 hours hours 0-6 hours Intravenous tpa therapy* ECASS III positive Intra-arterial tpa therapy Catheter devices
7 Real-time, full-motion video on broadband width network The Edmonton Telestroke Program In 2003, CH launched TeleStroke to extend specialized stroke care to patients in remote locations. Northern & Central Alberta; Territories, British Columbia and Saskatchewan. Acute TeleStroke program launched in Currently TeleStroke has 52 available sites for clinic visits / / / /07 Yellowknife, NWT - 1,499 km / / / / / / / /09 Tele-stroke clinic TIA (definite + possible) 45 % Stroke follow up 30 % The Acute Telestroke program Seizures / tumor 3 % Migraines 12% Others 15 %
8 Primary Stroke Care Centers - Partnering Remote Sites Hinton Health Care Center April 2006 Camrose Health Care Center June 2007 Cold Lake Health Care Center September 2007 Red Deer Hospital February 2008 Wainwright Nov 2008 Telestroke Patient 1 Patient 1 Case 1 (cont) This patient received intravenous tpa from the Camrose stroke team with telehealth involvement of the Capital Health/UAH Stroke Team Transferred to the UAH for further investigations to determine etiology Current Stats with acute stroke program
9 Consultations to date Total acute stroke consults IV t PA given - 50 Male - 60 % (thrombolysed) Average age - 68 ( 20 93) Diagnosis in the 216 patients Patient treated with tpa 50 Rapid recovery 51 Outside of window 46 Non stroke symptoms 12 ICH/SAH 5 Others 52 Overall results in treated patients Televideo conferencing 38 Teleconsultations 12 Onset to ER 101 m CT to needle 61 m Onset to tpa 162 m Complications Mortality in 90 days 10 patients Symptomatic hemorrhage 2 Asymptomatic hemorrhage 3 No difference in treatment with the two type of treatments
10 ECH Coverage Area SMH CVA STATISICS Stroke Patient Numbers ¾ 20.4% Received Thrombolytics (rtpa) (National Average 3-5%) ¾ 18.2% Transferred to Stroke Rehabilitation Unit Edmonton Lloydminster Camrose 3 1 Wainwright 2 SMH TIA STATISICS Stroke TIA Numbers ¾ 138 TIA Patients ¾ 1.5% Progressed to full Stroke ¾ 100% Carotid Doppler within 24 hours for high risk TIA SMH Patient Data ¾ Year prior to telestroke 115 patients transferred to UAH for management ¾ Second year of telestroke 15 patients transferred to UAH SMH Time Indicators ¾ Door to CT = 6 minutes ¾ CT to rt-pa = 37 minutes ¾ Total Door to Drug minutes minutes* Wainwright Portable CT
11 Results in the first 3 months 2: The second scan 24 hours after treatment with tpa shows a small paticheal hemorrhage in the region of the stroke. Total consultations 20 Patients treated with tpa 3 Patients with brain hemorrhage 3 Others 16 Patients transferred to UAH 1 Patient 3: The pre-treatment and post-treatment scans do not show any evidence of any ischemic damage in the third patient. This figure shows the CT scan of the only patient who required transfer to a tertiary care facility for treatment of the SAH These CT scans are of the two patients who had presented within three hours from onset of symptoms and were being considered for thrombolysis but the imaging showed large cerebral hemorrhages Conclusions 1. TeleStroke is an acceptable alternative for stroke patients from remote areas. 2. Improved access to specialized stroke care from remote Northern & Central Alberta and surrounding area, especially for prevention. 3. There is room for further expansion of the program in the province.
TIME LOST IS BRAIN LOST. TARGET: STROKE CAMPAIGN MANUAL
TIME LOST IS BRAIN LOST. TARGET: STROKE CAMPAIGN MANUAL 2010, American Heart Association TARGET: STROKE CAMPAIGN MANUAL 01 INTRODUCTION Welcome to the Target: Stroke. The purpose of this manual is to provide
More informationALBERTA PROVINCIAL STROKE STRATEGY (APSS)
ALBERTA PROVINCIAL STROKE STRATEGY (APSS) Stroke Systems of Care Key Components APSS Pillar Recommendations March 28, 2007 1 The following is a summary of the key components and APSS Pillar recommendations
More informationDeveloping a Dynamic Team Approach to Stroke Care. Emergency Medical Services 2015
Developing a Dynamic Team Approach to Stroke Care Emergency Medical Services 2015 Why Stroke, Why now? A recent study showed that 80 percent of people in the United States live within an hour s drive of
More informationAccreditation and Certification Guidelines
Accreditation and Certification Guidelines MARTIN GIZZI, MD, PHD, FAHA CHAIR, NJ NEUROSCIENCE INSTITUTE AT JFK CHAIR, NORTH EAST CEREBROVASCULAR CONSORTIUM (NECC) CHAIR, STROKE ADVISORY PANEL, NJDOH MEMBER,
More informationLevel III Stroke Center Data Collection Requirements
Who? Level III Stroke Center Data Collection Requirements All LERN Level III Stroke Centers. LERN Level I and II Stroke Centers have reporting requirements to The Joint Commission or other Board approved
More informationDisclosures. Georgia Facts. Stroke System Models. Telestroke. The World is Flat : A Brief Future of Acute Stroke Care
Telestroke The World is Flat : A Brief Future of Acute Stroke Care David C. Hess M.D. Department of Neurology Medical College of Georgia Disclosures Genentech Speaker s Bureau Boehringer Ingelheim Speaker
More informationAdvances in Stroke Care
Advances in Stroke Care 2015 Friday October 2 7 a.m. to 4:30 p.m. Hyatt Regency New Brunswick Two Albany Street New Brunswick, NJ 08901 Jointly sponsored by the Comprehensive Stroke Center Robert Wood
More informationGP workshop. Maria Fitzpatrick Nurse Consultant Kings College Stroke Centre
GP workshop Maria Fitzpatrick Nurse Consultant Kings College Stroke Centre Stroke: the Facts Stroke: the Facts Every 5 minutes someone in the UK has a stroke 1 in 4 men and 1 in 5 women will have a stroke
More informationApproved: Acute Stroke Ready Hospital Advanced Certification Program
Approved: Acute Stroke Ready Hospital Advanced Certification Program The Joint Commission recently developed a new Disease- Specific Care Advanced Certification program for Acute Stroke Ready Hospitals
More informationStroke is the No. 3 Killer in the United States and in New Mexico Two people in New Mexico die every day from stroke Eight people in NM become stroke
UNM Stroke Program and Telehealth Marc Malkoff MD Professor of Neurosurgery and Neurology ogy Medical Director Stroke Program and NSI UNMH 2 What Is The Impact Of Stroke? Stroke is the No. 3 Killer in
More informationTPA, STROKE, & TELEMEDICINE. Improving utilization and improving outcomes in a constantly evolving field
TPA, STROKE, & TELEMEDICINE Improving utilization and improving outcomes in a constantly evolving field OVERVIEW tpa inclusion and exclusion evolution Challenges to tpa administration Target:Stroke Telemedicine
More informationTELEMEDICINE AT UPMC UPMC TELEMEDICINE
TELEMEDICINE AT UPMC Telemedicine offers an unprecedented opportunity to expand health care expertise to patients at any time in any geographic area. With more than $1 billion invested in information technology
More informationStroke Systems of Care
Stroke Systems of Care Ashutosh P. Jadhav, MD PhD Assistant Professor, Neurology and Neurological Surgery Center for Neuro-endovascular Therapy UPMC Stroke Institute Pittsburgh, PA Stroke chain of survival
More informationStroke Care First week
Stroke Care First week Florence Nightingale (1820 1910) Stroke Unit Dedicated personnel trained in stroke management Stepwise guidelines supported by explicit checklists Continuous monitoring available
More informationTherapeutic Management Options for. Acute Ischemic Stroke Anna Rosenbaum, MD
Therapeutic Management Options for Acute Ischemic Stroke Anna Rosenbaum, MD Epidemiology Epidemiology 4 th leading cause of death in the United States 1 Leading cause of disability Increase in projected
More informationTelemedicine In Arkansas: A Rural State s Experience
Telemedicine In Arkansas: A Rural State s Experience Julie Hall-Barrow, Ed.D. University of Arkansas for Medical Sciences Center for Distance Health Medically Underserved Areas In a state where 73 of 75
More informationMedical Management of Ischemic Stroke: An Update. Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center
Medical Management of Ischemic Stroke: An Update Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center Objectives Diagnostic evaluation and management of acute ischemic stroke. Inpatient management
More informationDepartment of Veterans Affairs VHA DIRECTIVE 2011-038 Veterans Health Administration Washington, DC 20420 November 2, 2011
Department of Veterans Affairs VHA DIRECTIVE 2011-038 Veterans Health Administration Washington, DC 20420 TREATMENT OF ACUTE ISCHEMIC STROKE (AIS) 1. PURPOSE: This Veterans Health Administration (VHA)
More informationWhat is the Role of Telestroke in Stroke Systems of Care?
What is the Role of Telestroke in Stroke Systems of Care? Jeffrey A. Switzer, D.O. Director of Telestroke and Teleneurology Vascular Neurology Georgia Health Sciences University Disclosures Funding/grant
More informationWhat Is an Arteriovenous Malformation (AVM)?
What Is an Arteriovenous Malformation (AVM)? From the Cerebrovascular Imaging and Intervention Committee of the American Heart Association Cardiovascular Council Randall T. Higashida, M.D., Chair 1 What
More informationImaging of Acute Stroke. Noam Eshkar, M.D New Jersey Neuroscience Institute JFK Medical Center Edison Radiology Group
Imaging of Acute Stroke Noam Eshkar, M.D New Jersey Neuroscience Institute JFK Medical Center Edison Radiology Group Modalities Non Contrast CT (NCCT) Contrast CT Angiography MRI MR Angiography Perfusion
More informationSTROKE PREVENTION AND TREATMENT MARK FISHER, MD PROFESSOR OF NEUROLOGY UC IRVINE
STROKE PREVENTION AND TREATMENT MARK FISHER, MD PROFESSOR OF NEUROLOGY UC IRVINE CASE REPORT: ACUTE STROKE MANAGEMENT 90 YEAR OLD WOMAN, PREVIOUSLY ACTIVE AND INDEPENDENT, CHRONIC ATRIAL FIBRILLATION,
More informationThe Quality of Stroke Care in Canada. Canadian Stroke Network
Canadian Stroke Network 2011 ACKNOWLEDGEMENTS was funded and authored by the Canadian Stroke Network using the database and methodology developed for the Registry of the Canadian Stroke Network. The Canadian
More informationThe New Complex Patient: The Shifting Locus of Care and Cost. Does Technology Keep Patients Out of Hospitals?
The New Complex Patient: The Shifting Locus of Care and Cost Does Technology Keep Patients Out of Hospitals? Lee H. Schwamm, MD Executive Vice Chairman, Department of Neurology, Director of Stroke Services
More informationAppendix L: HQO Year 1 Implementation Priorities
Appendix L: HQO Year 1 Implementation Priorities Chronic Obstructive Pulmonary Disease (Source: COPD Chairs) Non-Invasive Positive Pressure Ventilation Early Ambulation If possible, seek patient preferences
More informationStroke Coding Issues Presentation to: NorthEast Cerebrovascular Consortium
Stroke Coding Issues Presentation to: NorthEast Cerebrovascular Consortium October 30, 2008 Barry Libman, RHIA, CCS, CCS-P President, Barry Libman Inc. Stroke Coding Issues Outline Medical record documentation
More informationWhat You Should Know About Cerebral Aneurysms
What You Should Know About Cerebral Aneurysms From the Cerebrovascular Imaging and Interventions Committee of the American Heart Association Cardiovascular Radiology Council Randall T. Higashida, M.D.,
More information4th Annual New York Stroke Conference Maximizing Stroke Quality of Care: Key Ingredients
4th Annual New York Stroke Conference Maximizing Stroke Quality of Care: Key Ingredients Thomas Kwiatkowski, MD Medical Director : Center for Emergency Medical Services NSLIJ No relevant financial relationships
More informationBuilding an Emergency Response to Acute Stroke
Great Lakes Stroke Network August 2006 Building an Emergency Response to Acute Stroke Wende N. Fedder RN, BSN, MBA Director, Stroke & Neurovascular Services Alexian Brothers Hospital Network Elk Grove
More informationStroke Transfers. Downstate Receiving Hospital Perspective
Stroke Transfers Downstate Receiving Hospital Perspective Jeffrey M. Katz, MD Director, North Shore University Hospital Stroke Center Assistant Professor of Neurology, Hofstra North Shore-LIJ School of
More informationMain Effect of Screening for Coronary Artery Disease Using CT
Main Effect of Screening for Coronary Artery Disease Using CT Angiography on Mortality and Cardiac Events in High risk Patients with Diabetes: The FACTOR-64 Randomized Clinical Trial Joseph B. Muhlestein,
More information2016 International Stroke Conference Hot Topics Lori M. Massaro, MSN, CRNP Kari Moore, MSN, AGACNP-BC
2016 International Stroke Conference Hot Topics Lori M. Massaro, MSN, CRNP Kari Moore, MSN, AGACNP-BC Disclosures Lori M. Massaro, MSN,CRNP speakers bureau Genentech Kari Moore, MSN, AGACNP-BC -none 1
More informationDetailed Technology Analysis Tele-Stroke
Detailed Technology Analysis Tele-Stroke Introduction Each year, just under 800,000 Americans have a stroke. The most promising treatment for ischemic (closed vessel) strokes, which occur in 87 percent
More informationdoi: 10.1016/j.jocn.2010.10.005
doi: 10.1016/j.jocn.2010.10.005 A remote desktop-based telemedicine system Yasushi Shibata, MD, PhD Department of Neurosurgery, Mito Medical Center, University of Tsukuba Mito, Ibaraki, 310-0015, Japan
More informationREMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as "Stroke Service" in Cerner.
ACUTE STROKE CLINICAL PATHWAY QEH/HH PCH KCMH Souris Western Stewart Memorial O'Leary PATIENT ID INCLUSION CRITERIA* All patients admitted to hosptial with a suspected diagnosis of acute ischemic stroke
More informationWhat do these stories illustrate about ER/ALC issue?
What do these stories illustrate about ER/ALC issue? Maximizing the Impact of Rehab on Provincial Priority Issues Mark Bayley, MD, FRCPC Medical Director, Neuro Rehabilitation Program, Toronto Rehab and
More informationTelestroke Area Overview/Statement of Problem
Telestroke Area Overview/Statement of Problem The burden of stroke in North Carolina is one of the highest in the nation. From 2003-2007, there were 27,927 stroke hospitalizations in the state (Huston,
More informationHospital-Based Sub-Acute Stroke Care and Secondary Prevention. Timothy Lukovits,, M.D.
Hospital-Based Sub-Acute Stroke Care and Secondary Prevention Timothy Lukovits,, M.D. Volunteer group members Shalini Bansil,, MD Summit NJ Ji Chong,, MD, NYC, NY Srinath Kadimi,, M.D. Fairfield, CT Steve
More informationMaking the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA
Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA Disclosures Jeanie Luciano Genentech speakers bureau Claranne Mathiesen - none 1 Objective
More informationStroke Telemedicine Services: A Guide to the Commissioning and Provision
Stroke Telemedicine Services: A Guide to the Commissioning and Provision Author: Professor Tony Rudd, National Clinical Director for Stroke Date: December 2014 First produced in August 2010 by Dr Damian
More informationMobile Stroke Treatment Units: A New Systems Concept
Mobile Stroke Treatment Units: A New Systems Concept Peter A. Rasmussen, MD on behalf of the CV Center and CCT Director, Cerebrovascular Center Associate Professor Surgery (Neurosurgery) Medical Director
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Supplemental Methods Online Information Search detailed description A highly inclusive first pass strategy for identifying possible programs was undertaken. A search for telemedicine
More informationKing County EMS Stroke Quality Improvement Program
King County EMS Stroke Quality Improvement Program A Report from the King County EMS Medical QI Section March 2012 Prepared by Sofia Husain, Jim Duren, and Norm Nedell OBJECTIVE The goal of the King County
More informationJournal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators
Journal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators Shaikha Al Naimi Doctor of Pharmacy Student College of Pharmacy Qatar University
More informationCASE SELECTION: EVALUATING THE RECORDS TO DETERMINE WHICH CASES TO REJECT OR TAKE
CASE SELECTION: EVALUATING THE RECORDS TO DETERMINE WHICH CASES TO REJECT OR TAKE Philip C. Henry, Esquire Henry, Spiegel, Fried & Milling, LLP Suite 2450 950 East Paces Ferry Road Atlanta, Georgia 30326
More informationProvidence Telemedicine Network
Providence Telemedicine Network Around the clock, around the region, our specialists are with you when every minute counts. Telemedicine brings our specialists to your hospital It is exciting to report
More informationGregory E. Young, MD, F.A.C.E.P. Medical Director, Western Region New York State Department of Health
Gregory E. Young, MD, F.A.C.E.P. Medical Director, Western Region New York State Department of Health Public Health Impact of Strokes: United States Every 45 seconds, someone in the U.S. has a stroke.
More informationCHAPTER 9 DISEASES OF THE CIRCULATORY SYSTEM (I00-I99)
CHAPTER 9 DISEASES OF THE CIRCULATORY SYSTEM (I00-I99) March 2014 2014 MVP Health Care, Inc. CHAPTER 9 CHAPTER SPECIFIC CATEGORY CODE BLOCKS I00-I02 Acute rheumatic fever I05-I09 Chronic rheumatic heart
More informationTable e-1: Description of the three participating centres Umeå, Sweden Dublin, Ireland Barcelona, Spain Population-based study with single
Table e-1: Description of the three participating centres Umeå, Sweden Dublin, Ireland Barcelona, Spain Population-based study with single Study setting stroke centre in a Population study small city,
More informationMaking Sense of the New Statin guidelines. They are more than just lowering your cholesterol!
Making Sense of the New Statin guidelines They are more than just lowering your cholesterol! No Disclosures Margaret (Peg) O Donnell DNPs, FNP, ANP B-C, FAANP Senior Nurse Practitioner South Nassau Communities
More informationAnticipated Date of Discharge Initial Audits
Anticipated Date of Discharge Initial Audits ADOD To follow up on the roll out of the white board documentation of the Anticipated Date of Discharge (ADOD), we have done audits of over 300 white boards
More informationRenovascular Hypertension
Renovascular Hypertension Philip Stockwell, MD Assistant Professor of Medicine (Clinical) Warren Alpert School of Medicine Cardiology for the Primary Care Provider September 28, 201 Renovascular Hypertension
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationEMS Management of Stroke. Deaver Shattuck, M.D. Brian Wiseman, M.D. Keith Woodward, M.D.
EMS Management of Stroke Deaver Shattuck, M.D. Brian Wiseman, M.D. Keith Woodward, M.D. Financial Disclosure: No relevant financial relationship exists Working Together to End Stroke Formed in 2013 Identified
More informationIs this pt s brain dysfunction due to ischemia? Onset & progression of sx; location of deficit
CEREBROVASCULAR ACCIDENTS & TIA s Maggie Kelly History: Onset of symptoms exact time Previous sxs suggestive of TIA s Progression of symptoms Headache? Medications Past history of CVA, clotting events
More informationIschaemic stroke 85% (85 in every 100 strokes)
UNDERSTANDING STROKE DUE TO INTRACEREBRAL HAEMORRHAGE This factsheet provides information for people who have had a stroke due to an intracerebral (bleed in the brain) and for their families and carers.
More informationJames F. Kravec, M.D., F.A.C.P
James F. Kravec, M.D., F.A.C.P Chairman, Department of Internal Medicine, St. Elizabeth Health Center Chair, General Internal Medicine, Northeast Ohio Medical University Associate Medical Director, Hospice
More informationAmerican Stroke Association Highlights Carla D. English, MHS, MHSA
AMERICAN STROKE ASSOCIATION HIGHLIGHTS 1 CARLA D. ENGLISH, MHS, MHSA QUALITY & SYSTEMS IMPROVEMENT GREATER SOUTHEAST AFFILIATE ASA VISION: Empower people to live longer, healthier lives free of stroke
More informationDirect-to-CT. QuICR Webinar November 4 2015
Direct-to-CT QuICR Webinar November 4 2015 Our ER Camrose offers 24 hour Emergency Room Care to our community We serve an approximate city/county population of 26,000 people Our ER visits totaled 17,931
More informationVirginia Medical Center Adopts Immersive Video
Executive Summary University of Virginia Health System Center for Telehealth Industry: Academic Medical Center Location: Charlottesville, Virginia CHALLENGE Need to increase and support practitioners in
More informationIsis Innovation & Oxford AHSN Technology Showcase. ehealth & Big Data
Isis Innovation & Oxford AHSN Technology Showcase Improving Stoke Treatment with Medical Imaging Dr Michalis Papadakis CEO & Co-Founder Brainomix Oxford University start up Vision: leaders in medical imaging
More informationAHA/ASA Scientific Statement
AHA/ASA Scientific Statement Metrics for Measuring Quality of Care in Comprehensive Stroke Centers: Detailed Follow-Up to Brain Attack Coalition Comprehensive Stroke Center Recommendations A Statement
More informationEmergency Telemedicine Services
Emergency Telemedicine Services Emergency care delivered through telemedicine can support patients who require immediate assessment and treatment (as soon as a remote consultant is available) or patients
More informationSTROKE OCCURRENCE SYMPTOMS OF STROKE
STROKE OCCURRENCE SYMPTOMS OF STROKE The symptoms of stroke depend on what part of the brain is affected and how large an area is involved. A stroke is a sudden event accompanied by one or more of the
More informationPreparing Your Hospital for Primary Stroke Certification Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN Claranne Mathiesen, MSN, RN, CNRN
Preparing Your Hospital for Primary Stroke Certification Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN Claranne Mathiesen, MSN, RN, CNRN Disclosures Wendy J. Smith-I have no actual or potential conflict
More informationTelemedicine Offers Growth for Hospitals, Rural Care Opportunities
Telemedicine Offers Growth for Hospitals, Rural Care Opportunities The internet and digital technology have transformed our lives, changing the way we keep in touch with our family and friends, shop, pay
More informationFall 2013. A progress report on improving rehabilitative care in Waterloo Wellington
Fall 2013 A progress report on improving rehabilitative care in Waterloo Wellington The Waterloo Wellington Rehabilitative Care Council Improving rehabilitative care in Waterloo Wellington, fall 2013,
More informationHealth Minister Horne misinformed about medevac system Doctors say government will be putting lives at risk
Press Release Website: www.saveourmedevac.ca January 21, 2013 For Immediate Release 8:00 pm Health Minister Horne misinformed about medevac system Doctors say government will be putting lives at risk Edmonton:
More informationStroke: Major Public Health Burden. Stroke: Major Public Health Burden. Stroke: Major Public Health Burden 5/21/2012
Faculty Prevention Sharon Ewer, RN, BSN, CNRN Stroke Program Coordinator Baptist Health Montgomery, Alabama Satellite Conference and Live Webcast Monday, May 21, 2012 2:00 4:00 p.m. Central Time Produced
More informationTexas Heart Attack and Stroke Data Collection Initiative: Data Update. Nimisha Bhakta, MPH Texas Heart Attack and Stroke Summit July 24, 2015
Texas Heart Attack and Stroke Data Collection Initiative: Data Update Nimisha Bhakta, MPH Texas Heart Attack and Stroke Summit July 24, 2015 Presenter Disclosure Information FINANCIAL DISCLOSURE: I have
More informationCERTIFICATE OF NEED AND ACUTE CARE LICENSURE PROGRAM. Hospital Licensing Standards: Emergency Department and Trauma Services:
HEALTH AND SENIOR SERVICES HEALTH CARE QUALITY AND OVERSIGHT BRANCH HEALTH CARE QUALITY AND OVERSIGHT DIVISION ACUTE CARE FACILITY OVERSIGHT CERTIFICATE OF NEED AND ACUTE CARE LICENSURE PROGRAM Hospital
More informationLong term care coding issues for ICD-10-CM
Long term care coding issues for ICD-10-CM Coding Clinic, Fourth Quarter 2012 Pages: 90-98 Effective with discharges: October 1, 2012 Related Information Long Term Care Coding Issues for ICD-10-CM Coding
More informationStrategic Planning for Stroke Center Accreditation/Certification. Suzanne Borgos, MBA/MHA VP, Planning
Strategic Planning for Stroke Center Accreditation/Certification Suzanne Borgos, MBA/MHA VP, Planning Disclosures I have no pertinent relationships to disclose. 2 Stroke Care at Capital Health Regional
More informationAlberta s chiropractors: Spine care experts Patient satisfaction and research synopsis
www.albertachiro.com 11203 70 Street NW Edmonton, AB T5B 1T1 Telephone: 780.420.0932 Fax: 780.425.6583 Alberta s chiropractors: Spine care experts Patient satisfaction and research synopsis Chiropractic
More informationThrombolysis for Ischemic Stroke: Past, Present, and Future. LGH Stroke Symposium Oct 26, 2013
Thrombolysis for Ischemic Stroke: Past, Present, and Future LGH Stroke Symposium Oct 26, 2013 1 2 Thrombolytic Therapy Outcomes at 3 Months from tpa Treatment of Stroke 4 Historical Landmarks 5 Other Thrombolytics
More informationDo We Need a New Definition of Stroke & TIA as Proposed by the AHA? Stroke & TIA need to Remain Clinical Diagnoses: to Change Would be Bonkers!
Do We Need a New Definition of Stroke & TIA as Proposed by the AHA? No Stroke & TIA need to Remain Clinical Diagnoses: to Change Would be Bonkers! A/Prof Anne L. Abbott Neurologist School of Public Health
More informationSTROKE SERIES SS10. Understanding thrombolysis treatment For stroke
STROKE SERIES SS10 Understanding thrombolysis treatment For stroke Chest Heart & Stroke Scotland improves the quality of life for people in Scotland affected by chest, heart and stroke illness, through
More informationwhy? 75 percent The percentage of healthy individuals over age 40 who will become critically ill at some time in the future. 3
Elite coverage can help protect your savings. USAble Life s 1 coverage helps protect your family from the financial impact that can occur as the result of a heart attack, stroke or even cancer by providing
More informationThe Independent Order Of Foresters ( Foresters ) Critical Illness Rider (Accelerated Death Benefit) Disclosure at the Time of Application
The Independent Order of Foresters ( Foresters ) - A Fraternal Benefit Society. 789 Don Mills Road, Toronto, Canada M3C 1T9 U.S. Mailing Address: P.O. Box 179 Buffalo, NY 14201-0179 T. 800 828 1540 foresters.com
More informationWhat is Vascular Surgery Worth to a Health Care System?
What is Vascular Surgery Worth to a Health Care System? Peter Gloviczki, MD Robert Zwolak, MD Sean Roddy, MD Conflict of Interest NONE Mayo Clinic, Rochester, MN, Dartmouth-Hitchcock Medical Center, Lebanon,
More informationBest Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN
Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN Physician Education Session May 24, 2013 Dr. Mark Bayley,, Cheryl
More informationAR SAVES. INTRODUCTION AND UPDATES FOR ER PHYSICIANS. Nicolas Bianchi, MD. August 23 rd, 2012.
1 AR SAVES INTRODUCTION AND UPDATES FOR ER PHYSICIANS. Nicolas Bianchi, MD. August 23 rd, 2012. 2 Objectives To provide an introduction and overall description of AR SAVES as a Telestroke Network in the
More informationDepression in Older Persons
Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression
More informationPhilips Hospital to Home: redefining healthcare. through innovation in telehealth
Philips Hospital to Home: redefining healthcare through innovation in telehealth Healthcare costs are at a crisis point, forcing the federal government to make comprehensive changes to healthcare payment
More informationTransfer of Care Guideline for Stroke Patients Stroke Reperfusion Workgroup
Transfer of Care Guideline for Stroke Patients Stroke Reperfusion Workgroup Contact: Mark Longworth, Stroke Network Manager, ACI, Mob 0417 680 482, Tel 02 8644 2188 Mark.Longworth@aci.health.nsw.gov.au
More informationPerformance Monitoring for Commissioners: Out-of-hours Telestroke Service
Performance Monitoring for Commissioners: Out-of-hours Service Introduction The detailed specification for the Cumbria and Lancashire out of hours project was to provide a consultant led out of hours Telemedicine
More informationMEDICARE PAYMENT OF TELEMEDICINE AND TELEHEALTH SERVICES January 22, 2007
MEDICARE PAYMENT OF TELEMEDICINE AND TELEHEALTH SERVICES January 22, 2007 The Center for Medicare and Medicaid Services (CMS) administers Medicare programs in the United States. Currently, Medicare provides
More informationTelestroke e-bulletin
Telestroke e-bulletin Happy New Year and welcome to the first edition of the Telestroke e-bulletin for 2012. We have achieved a lot in the last year with the ever successful implementation and launch of
More informationAcute Myocardial Infarction (the formulary thrombolytic for AMI at AAMC is TNK, please see the TNK monograph in this manual for information)
ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Alteplase (Tissue Plasminogen Activator (t-pa)), Activase in the Treatment
More informationUsing the Pupillometer in Clinical Practice
Using the Pupillometer in Clinical Practice Claude Hemphill MD M.A.S. chmephill@sfgh.ucsf.edu Kathy Johnson RN, MSN KJOHNSON@queens.org Mary Kay Bader RN, MSN, CCNS Badermk@aol.com Pupillometry: How It
More informationDELAWARE DISTRICT OF COLUMBIA MARYLAND. State- Specific Information Recent news, pending action:
State DELAWARE DISTRICT OF COLUMBIA MARYLAND State- Specific Information Recent news, June 27, 2012 - Delaware Medicaid program to reimburse for telemedicine- delivered services beginning July 1. Delaware
More informationThe Clinical Evaluation of the Comatose Patient in the Emergency Department
The Clinical Evaluation of the Comatose Patient in the Emergency Department patients with altered mental status (AMS) and coma. treat patients who present to the Emergency Department with altered mental
More informationELSO GUIDELINES FOR ECMO CENTERS
ELSO GUIDELINES FOR ECMO CENTERS PURPOSE These guidelines developed by the Extracorporeal Life Support Organization, outline the ideal institutional requirements needed for effective use of extracorporeal
More information3152 Registered Nurses
3152 Registered Nurses This unit group includes registered nurses, nurse practitioners, registered psychiatric nurses and graduates of a nursing program who are awaiting registration (graduate nurses).
More informationTHE INTERNET STROKE CENTER PRESENTATIONS AND DISCUSSIONS ON STROKE MANAGEMENT
THE INTERNET STROKE CENTER PRESENTATIONS AND DISCUSSIONS ON STROKE MANAGEMENT Stroke Prevention in Atrial Fibrillation Gregory Albers, M.D. Director Stanford Stroke Center Professor of Neurology and Neurological
More informationEdmonton Consortium Clinical Psychology Residency
Edmonton Consortium Clinical Psychology Residency Frequently Asked Questions 1. How do I apply to the Edmonton Consortium Clinical Psychology Program? The Edmonton Consortium is a member of the Association
More informationA Collaborative Effort to Improve Emergency Stroke Care: Mobile Stroke Unit
A Collaborative Effort to Improve Emergency Stroke Care: Mobile Stroke Unit What can we do to cut down the time it takes to give a clot dissolving drug (tpa)? MOBILE STROKE UNIT! Mobile Stroke Unit Mobile
More informationS9 Administer thrombolytic treatment in acute ischaemic stroke
S9 Administer thrombolytic treatment in acute ischaemic Screening and initiating treatment, overseeing competency of treatment About this workforce competence This competence is about the emergency administration
More informationTelemedicine as Part of Your Service Line Strategy. Howard J. Gershon, FACHE Principal, New Heights Group March 2011
Telemedicine as Part of Your Service Line Strategy Howard J. Gershon, FACHE Principal, New Heights Group March 2011 1 Session objectives Understand the concept of telemedicine/telemedicine and how it is
More informationStroke Thrombolysis Awareness. Initial patient assessment. Using F.A.S.T., Rosier, & NIHSS Tools
Stroke Thrombolysis Awareness Initial patient assessment Using F.A.S.T., Rosier, & NIHSS Tools Adapted from 5 Acute Trusts - 6 Primary Care Trusts Ambulance Trust 4 Local Authorities Aims Improve recognition
More information