TeleBAT: Mobile telemedicine for the brain attack team

LaMonte, Marian P.; Cullen, James; Gagliano, David; Gunawardane, Ruwani; Hu, Peter; Mackenzie, Colin F.; Xiao, Yan

doi:10.1053/jscd.2000.5867

Cited by 65 publications

(53 citation statements)

References 5 publications

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“…Up to now, evaluation of video transmission from an ambulance-located telemedicine system has been reported in one project, the mobile telemedicine for the Brain Attack Team (TeleBAT). 9,10 Furthermore, several studies provide evidence that remote assessment of stroke severity such as National Institutes of Heath Stroke Scales (NIHSSs) is feasible and reliable in the interhospital setting. 11,12 However, data on prehospital real-time stroke severity assessment by a hospital-based stroke physician in patients during ambulance transport in a moving vehicle are limited.…”

mentioning

confidence: 99%

Telestroke Ambulances in Prehospital Stroke Management

Liman

Winter

Waldschmidt

et al. 2012

Stroke

101

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Background and Purpose-Pre-and intrahospital time delays are major concerns in acute stroke care. Telemedicineequipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Methods-Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. Results-In

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mentioning

confidence: 99%

Telestroke Ambulances in Prehospital Stroke Management

Liman

Winter

Waldschmidt

et al. 2012

Stroke

101

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“…[2][3][4] This completely precluded real-time conferencing in TeleBat 2,3 and yielded frequent inadequate assessments in a recent study using 3G technology. 4 The need for trained professional support at the patient's bedside for assessment of the NIHSS is a major drawback in the prehospital setting, which can be overcome by the UTSS.…”

Section: Discussionmentioning

confidence: 99%

“…Standardized evaluation of stroke severity is pivotal for adequate treatment decision making, but remote quantification of stroke severity remains challenging because current stroke scales require trained professional support at the patient's bedside. [2][3][4] We recently developed a scale for assessing stroke severity through telemedicine without assistance from a third party (Unassisted TeleStroke Scale [UTSS]). 5 This study aims to evaluate the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the UTSS via a telestroke ambulance system and a fourth-generation mobile network.…”

mentioning

confidence: 99%

Prehospital Unassisted Assessment of Stroke Severity Using Telemedicine

Hooff

Cambron

Dyck³

et al. 2013

Stroke

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Background and Purpose-We evaluated the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the Unassisted TeleStroke Scale (UTSS) via a telestroke ambulance system and a fourthgeneration mobile network. Methods-The technical feasibility and the reliability of the UTSS were studied in healthy volunteers mimicking 41 stroke syndromes during ambulance transportation. Results-Except for 1 issue, high-quality telestroke assessment was feasible in all scenarios. The mean examination time for the UTSS was 3.1 minutes (SD, 0.4). The UTSS showed excellent intrarater and interrater variability (ρ=0.98 and 0.97; P<0.001), as well as excellent internal consistency and rater agreement. Adequate concurrent validity can be derived from the strong correlation between the UTSS and the National Institutes of Health Stroke Scale (ρ=0.90; P<0.001). Conclusions-Remote assessment of stroke severity in fast-moving ambulances using a system dedicated to prehospital telemedicine, 4G technology, and the UTSS is feasible and reliable.

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“…Telestroke has been shown in several clinical studies [64][65][66][67][68][69][70][71][72][73][74] to have feasibility and safety, 65 acceptable inter-rater reliability of the virtual examination versus physical bedside examination, [65][66][67] increased thrombolysis treatment rates, improved clinical outcomes, [75][76][77][78][79] cost-effectiveness, 80 and enhanced opportunities for referring centers to gain stroke center designation status. 81,82 Telestroke is particular advantageous to the rural, underserved ED or hospital, [83][84][85][86][87][88][89][90] which may be challenged in recruiting specialists in relative short supply, including neurologists and subspecialists such as neurohospitalists, neurointensivists, and vascular neurologists.…”

Section: How Can Teleneurohospitalists Impact Patient Care?mentioning

confidence: 99%

Future Neurohospitalist

Freeman

Barrett

Vatz³

et al. 2012

The Neurohospitalist

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Despite the growing demand for emergency neurological evaluations and neurohospitalists, the supply of neurologists remains relatively fixed over time. Telemedicine is a unique tool that has the ability to put a medical specialist like a neurologist in 2 places in a relatively short period of time, expanding expertise in many rural and in some underserved urban facilities that would ordinarily be devoid of such expertise. Teleneurology is a branch of telemedicine that consults and practices through remote neurological evaluation. Telestroke is defined as remote stroke evaluation. The demand for timely neurological evaluation, especially acute stroke evaluation and treatment with intravenous recombinant tissue plasminogen activator (IV rtPA), continues to fuel the growth of neurohospitalists, telestroke, and teleneurology services. Remote, rural, or underserved urban emergency departments and hospitals which are unable to successfully recruit a neurologist or neurohospitalist to provide this service are uniquely suited to a teleneurology option. The number of private practices and academic centers providing telestroke services has grown significantly in the past decade with continued growth expected. We describe the benefits and drawbacks of teleneurology/telestroke, as well as other practical aspects for the teleneurohospitalist.

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TeleBAT: Mobile telemedicine for the brain attack team

Cited by 65 publications

References 5 publications

Telestroke Ambulances in Prehospital Stroke Management

Telestroke Ambulances in Prehospital Stroke Management

Prehospital Unassisted Assessment of Stroke Severity Using Telemedicine

Future Neurohospitalist

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