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New guidelines for stroke triage published in the AHA’s Stroke journal call on first responders to use telehealth and mHealth to screen and diagnose patients and ensure speedy transport to the right care facility.

By Eric Wicklund

May 28, 2020 – A team of stroke experts has published new guidelines calling for the increased use of telemedicine during triage and transport to improve patient care and outcomes.

Writing in the American Heart Association’s Stroke journal, the team calls on EMS crews to use connected health technologies to improve care management of stroke victims and speed transport to the facility that best meets the patient’s needs. This is especially vital at a time when treatment may be affected by concerns of coronavirus contamination.

“Now more than ever, during the COVID-19 pandemic, we need to work collaboratively and support our emergency medical services providers working day and night on the front lines for our community,” Andrew Southerland, MD, a stroke expert with the University of Virginia’s Departments of Neurology and Public Health Sciences, said in a release prepared by UVA. “To achieve this, we must optimize communication and prehospital care for patients.”

Along with Southerland, the team consists of Mayank Goyal, MD, and Johanna M. Ospel of the University of Calgary; Charles Wira of Yale University and the Yale Stroke Program; Sepideh Amin-Hanjani of the University of Illinois; Justin Fraser of the University of Kentucky; and Peter Panagos of the Washington University School of Medicine in St. Louis. They wrote the guidance on behalf of the American Stroke Council’s Emergency Neurovascular Care, Telestroke and Neurovascular Intervention Committees.

The report gives added weight to the value of telestroke services in delivering care as quickly as possible to patients suspected of having suffered a stroke. Studies have found that telehealth can shave valuable minutes off of treatment time, enabling care providers to administer intravenous tissue plasminogen activator (tPA) sooner, thereby lessening the chances of permanent brain damage and death.

The guidelines call on EMS crews to use mHealth tools whenever possible to screen patients for COVID-19 symptoms, and have a protocol in place if the patient can’t be screened or if the patient shows signs of infection.

In addition, because patients with the COVID-19 virus are more likely to need a ventilator and intensive care, emergency crews should take into consideration whether a hospital can provide that care. And they should be in contact with those hospitals to ensure timely transport.

“During the COVID-19 pandemic, it is more important than ever to ensure that the patient is transferred to the right hospital the first time around,” the guidelines note.

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