TELEMEDICINE AND RESEARCH.

THE TELEICTUS PROJECT IN THE HOSPITAL St JOHN OF GOD

´S OF ALJARAFE.

Antonio Fernández Moyano MD. PhD.Internal Medicine Service ChiefHospital St John of God´s to Aljarafe.Betica Province

•Stroke is the second leading cause of death in our country and the first long-term disability.

Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke.

Intravenous rtPA (alteplase) is recommended for selected patients who meet the following three conditions:

-< 80 years old

-within 4,5 hours of onset of symptoms, and

-NIHSS scale between 4-20 points

“thrombolytic therapy should only be given if the diagnosis is established by a physician who has expertise in the diagnosis of stroke, and a computed tomography (CT) of the brain isassessed by physicians who have expertise in reading this imaging study”.

2003

European Stroke Initiative. CerebrovascDis. 2004;17(suppl 2):30–46.

Much of the population live in geographically remote

from major medical centers, and the permanent

presence of a neurologist expert in each of the

regional hospitals is unfeasible.

2006

Telemedical support offers a novel and

pragmatic way to extend the benefits of

systemic thrombolysis to rural areas.

rtPA administration can be conducted in

regional hospitals with similar

treatment quality

Stroke 2006, 37:1822-1827:

Thrombolysis may be initiated at an outlying hospital (spoke) under the supervision of a vascular neurologist at the designated Regional stroke centre (Hub) via telephone or telemedicine (“telestroke”)

Stroke. 2010;41:e18-e24.

An organized protocol for the emergency

evaluation of patients with suspected stroke.

Designation of an acute stroke team that includes

physicians, nurses, and laboratory/radiology

personnel.

Stroke. 2010;41:e18-e24.

Population: 270.000

Hub: 80 m´

Spoke: 40 m´

ALJARAFE

Our program has developed a computer system to aid decision making in the clinical assessment of doctors and nurses,

… and treatment.