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远程医疗在院前卒中护理中的作用。

Role of Telemedicine in Prehospital Stroke Care.

机构信息

Department of Neurology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, 79905, USA.

出版信息

Curr Cardiol Rep. 2021 May 10;23(6):71. doi: 10.1007/s11886-021-01473-8.

Abstract

PURPOSE OF REVIEW

To summarize evidence for the feasibility and the efficacy of mobile stroke units (MSUs) and telemedicine in the field to reduce time delays in offering acute stroke interventions.

RECENT FINDINGS

A mobile stroke unit is a modified ambulance and includes sophisticated equipment, either trained personnel on board, or connection with skilled physicians via telemedicine. Stroke assessment and treatment agreeability between the on board and remote neurologist is high in MSUs. MSUs are the promising option to reduce stroke symptom onset to treatment time; telemedicine platform has a satisfactory audiovisual quality, high inter-rater reliability for remote stroke symptom assessment, diagnosis, and decision to treat. Use of MSU also avoids the need for inter-hospital transfers. MSUs improve prehospital stroke care and reduce delays in access to intravenous thrombolytic and mechanical thrombectomy in selective markets. Advancement in telecommunication and modern technology has the potential to make MSU telemedicine-aided management more cost-effective. Further research is needed before its widespread implementation.

摘要

目的综述

总结移动卒中单元(MSU)和远程医疗在现场应用的可行性和疗效,以减少急性卒中干预的时间延误。

最近的发现

移动卒中单元是一种改装的救护车,配备了先进的设备,车上有训练有素的人员,或者通过远程医疗与熟练的医生联系。MSU 中,船上和远程神经科医生之间的卒中评估和治疗一致性很高。MSU 是减少卒中症状发作到治疗时间的有前途的选择;远程医疗平台具有令人满意的视听质量,远程卒中症状评估、诊断和治疗决策的高观察者间可靠性。使用 MSU 还可以避免需要医院间转院。MSU 改善了院前卒中护理,并减少了在选择市场中获得静脉溶栓和机械取栓的时间延误。电信和现代技术的进步有可能使 MSU 远程医疗辅助管理更具成本效益。在广泛实施之前,还需要进一步研究。

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