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Telemedicine for acute neurological disease - gpt 2014
1. To Boldly Go Where No One Has
Beamed Before
Matthews Gwynn, MD
AcuteCare Telemedicine
2. • The 4th leading cause of death in the United States
• The #1 cause of adult disability in the United States
• 795,000 Americans suffer strokes each year
• 87% of strokes are ischemic, 13% are hemorrhagic
• 134,000 deaths each year
• 2,000,000 brain cells die every MINUTE during stroke
• Women are TWICE as likely to die from stroke than
breast cancer
• 6,400,000 stroke survivors (2% of U.S.)
Connect to Quality 2
3. • Audio/Video telemedicine evaluation of an acute
stroke patient leads to better decision-making and
safety than telephone only consultations
• The NIH Stroke Scale (NIHSS) via telestroke consult
is reliable
• Neurologists can reliably interpret brain CT images
to confirm the diagnosis of acute ischemic stroke
and establishing eligibility for IV-tPA
• IV-tPA can be administered safely through
telemedicine and with outcomes comparable to
those observed in patients being treated at tertiary
care centers
• Telestroke networks have been proven cost
effective
4. • 46 yo woman developed dysarthria, right hemiplegia
about 8:00 AM
• Quickly presented to Dale Medical Center
• Teleneurologist responded 2 minutes after receiving
call and performed consultation immediately
NIHSS=8
9. • 57 yo man developed lower extremity numbness and
weakness 2 days before presentation to local ER in
Tennessee. Upper extremities, bowel and bladder
normal.
• URI 2 weeks beforehand
• NE showed hyporeflexia with assistance from PA on
site
• BLE 4/5 weakness, especially proximally
• Diminished light touch and pain sensation from T12
on trunk down
• Able stand only with assistance