Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, April 22, 2021

In-Ambulance Stroke Consults Reduces Critical Treatment Time for Patients

But since you don't know how fast tPA needs to be delivered to get 100% recovery you have no goal to shoot for.  Please quit shooting in the dark with your research and just FUCKING SOLVE STROKE.  

So you saved 28.5 million neurons.

Big fucking whoopee.

15 minutes is nothing, you'll save 28.5 million neurons, a miniscule fraction of the billions that will be left to die by doing nothing to stop the 5 causes of the neuronal cascade of death in the first week.  You don't even know what the hell you are doing to solve stroke. GET THE HELL OUT AND LET SURVIVORS RUN IT.

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will ream me out for making them look bad by being truthful , I look forward to that day.

 

In-Ambulance Stroke Consults Reduces Critical Treatment Time for Patients

Prehospital stroke triaging using telestroke consultation in emergency medical services unit (TEMS) is feasible, and could result in shorter door-to-needle time and onset to groin times, according to a study published in the Journal of Stroke and Cerebrovascular Diseases.

Patients with stroke symptoms were evaluated via TEMS using a video call with a stroke provider. After TEMS evaluation, patients were transferred to the nearest stroke centre or thrombectomy capable center depending on stroke severity and symptom onset time.

“We realised that if we could start seeing these patients before they came into the emergency room, we could reduce the time it took for us to treat them,” said Christine Holmstedt, MD, Medical University of South Carolina, Charleston, South Carolina. “We compared time metrics between patients evaluated via TEMS to those via standard telestroke consultation.”

A total of 49 patients were evaluated via TEMS between May 2017 and March 2020. Median age was 66 years, 24 (49%) were females, 15 (30.6%) received intravenous alteplase (tPA) after arrival to a local hospital, and 3 (6.1%) underwent mechanical thrombectomy after bypassing the nearest stroke centre.

Compared with 52 patients who received tPA after standard telestroke consultation, TEMS patients had shorter door-to-needle time (21 min vs 38 min; P< .001). In addition, patients who received mechanical thrombectomy after bypassing the nearest stroke centre had shorter onset to groin time compared with those transferred from nearest stroke centre (216 min vs. 293 min; P = .04).

“A 15-minute reduction in door-to-treatment time leads to patients with reduced complications from tPA and significant reduction in disability or death,” said Dr. Holmstedt. “They are more likely to be discharged to an acute rehab rather than long-term care, and they have much better functional outcomes.”

This program is especially important in rural areas where patients are spread out geographically. Dr. Holmstedt is currently working to assess the economic impact of the telestroke program and the potential for further expansion.

“These improved outcomes reduce disability and even death for patients seen with acute stroke,” said Dr. Holmstedt. “And they don’t negatively impact the EMT workflow, so we can bring more efficient treatment options to the state’s rural population -- and that’s significant.”

Reference: https://www.strokejournal.org/article/S1052-3057(21)00113-0/fulltext

SOURCE: Medical University of South Carolina
 

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