Timeliness of Intravenous Thrombolysis via Telestroke in Georgia
Background and Purpose—Through 2-way live video and audio communication, telestroke enhances urgent treatment of patients with acute stroke in emergency departments (EDs) without immediate access to on-site specialists. To assess for opportunities to shorten the door to thrombolysis time, we measured multiple time intervals in a telestroke system.
Methods—We retrospectively analyzed 115 records of consecutive acute stroke patients treated with intravenous thrombolysis during a 20-month period via a statewide telestroke system in 17 EDs in Georgia. On the basis of times documented in the telestroke system, we calculated the time elapsed between the following events: ED arrival, telestroke patient registration, start of specialist consultation, head computed tomography, thrombolysis recommendation, and thrombolysis initiation.
Results—The most conspicuous delay was from ED arrival to telestroke patient registration (median, 39 minutes; interquartile range, 21–56). Median time from ED arrival to thrombolysis initiation was 88 minutes, interquartile range 75 to 105. Thrombolysis was initiated within 60 minutes from ED arrival in 13% of patients.
Conclusions—The greatest opportunity to expedite acute thrombolysis via telestroke is by shortening the time from ED arrival to telestroke patient registration.
- acute stroke
- intravenous tissue-type plasminogen activator
- ischemic stroke
- stroke care
- Received April 22, 2013.
- Revision received May 9, 2013.
- Accepted May 20, 2013.
- © 2013 American Heart Association, Inc.