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The use of telemedicine in the ambulance for more precise and rapid prehospital/emergency medical service (EMS) care of patients with acute stroke dates back to 1988 by the University of Maryland TeleBAT (telemedicine for the Brain Attack Team) system.1 The TeleBAT Team, which used this approach to determine the patient's NIH Stroke Scale (NIHSS) score, prophetically described a novel approach that could shorten the time to treatment because emergency medical technicians can transmit their videotaped assessment to the emergency room, providing emergency medicine physicians and neurologists with earlier viewing of the stroke patient's condition. Sending visual and audio data of the patient's neurologic status, vital signs, and laboratory data, many components of the clinical pathway (except head CT scanning—which can now be achieved with the mobile stroke units2,3) that lead to recombinant tissue plasminogen activator therapy, can be accomplished in the prehospital setting. Protocols can also be downloaded from the internet and used in the emergency room and ambulance. This integrated approach may lead to highly accurate clinical judgments once reliability and validity issues are addressed.3 This past decade has seen tremendous technological progress in advancing prehospital stroke care, including the successful completion of randomized clinical trials of prehospital administration of IV recombinant tissue plasminogen activator after in-field head CT scanning.4,5
Footnotes
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- © 2016 American Academy of Neurology
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