Abstract
Abstract P168: Who Are You Going to Call?: Emergency Physician Stroke Champions
Stroke (1970), v 52(Suppl_1)
Mar 2021
Abstract
Abstract only
Introduction:
A 2013 study supported by the American Academy of Neurology showed an 11% shortage of neurologists with a projected 19% shortage by 2025. An additional supply of 3000 neurologists is needed by 2025 to meet the looming demand. To help ease the shortage, teleneurology has been implemented by neurologists, mainly for acute stroke patients. We present our model of emergency physician Stroke Champions (SCs) to direct care for stroke patients.
Methods:
Administering thrombolytics for stroke is a key component of emergency medicine core competencies. Our health system consists of 4 hospitals; a main hub and 3 spoke hospitals. The hub hospital innovatively developed a Neurologic Emergency Department (Neuro ED) with 5 board certified emergency physicians dedicated to caring for patients with any type of neurological complaint. The Neuro ED physicians are also designated as SCs that have specialized training to provide teleneurology to fellow emergency physicians caring for acute stroke patients at the additional hospitals. This supplementary training consists of a mini neurology fellowship with rotations through the neurologic ICU, specialized stroke floor, neurointerventional suite, and neuroradiology.
Results:
Over a 90-day period the command center received 67 phone calls for patients that met stroke alert criteria. Calls entailed managing BP, dosing alteplase, and recommendations for advanced neuroimaging. Most importantly, the SCs extensively reviewed inclusion and exclusion criteria for IV alteplase with the spoke emergency physician. Three patients were deemed eligible for IV alteplase, with no cases of intracranial hemorrhage. Seven patients required transfer and was facilitated by the SCs, reducing any delays. Reasons for transfer included 3 cases of hemorrhagic stroke, 3 large vessel occlusions for mechanical thrombectomy - one of which received IV alteplase, and 1 brain tumor.
Conclusion:
Teleneurology is a reliable means of reaching and treating stroke patients. With the severe current shortage of neurologists in the U.S., we now demonstrate a promising alternative of emergency physician Stroke Champions providing telestroke care. This model has produced a high success rate raising the standard of acute neurological care.
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Details
- Title
- Abstract P168: Who Are You Going to Call?: Emergency Physician Stroke Champions
- Creators
- Erol Veznedaroglu - Neurosciences InstituteThomas Kurtz - Neurosciences InstituteMandy J Binning - Neurosciences InstituteKenneth M Liebman - Neurosciences InstituteZakaria Hakma - Neurosciences InstituteKaren J Greenberg - Neurosciences Institute
- Publication Details
- Stroke (1970), v 52(Suppl_1)
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Number of pages
- 2
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- MD (Doctor of Medicine) Program; Neurology; Neurosurgery; Emergency Medicine
- Web of Science ID
- WOS:000670883500287
- Other Identifier
- 991021903300504721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease