TY - CHAP M1 - Book, Section TI - Telestroke A1 - Southerland, Andrew M. A1 - Solenski, Nina J. A1 - Schwamm, Lee H. A2 - Rheuban, Karen Schulder A2 - Krupinski, Elizabeth A. Y1 - 1 N1 - T2 - Understanding Telehealth AB - Mr. Taylor is a 45-year-old man enjoying a summer vacation camping in rural southwest Virginia. He has been enjoying hiking and swimming with his wife and two young daughters for the last two days. Today at 5:25 P.M., his wife finds him in their tent “slumped over” with incomprehensible speech. She had just talked to him no more than 10 minutes prior and he seemed fine. She sees that his right side is paralyzed and immediately knows he needs emergency help. Emergency medical services (EMS) are summoned by the clerk at the park entrance. Mr. Taylor is lifted into the ambulance to be transported to the nearest hospital, which is a small 16-bed critical access hospital serving the surrounding rural area. During ambulance transport, the EMS provider identifies the patient as having a potential “stroke” using a validated prehospital stroke scale. Under a new protocol, the EMS provider connects with a telestroke neurologist at a regional academic medical center using a mounted tablet with 4G LTE connectivity. The neurologist reviews the history, medications, and vital signs with EMS and performs the NIH Stroke Scale (NIHSS). The neurologist's assessment suggests a severe stroke that may be eligible for thrombolytic treatment and perhaps a large vessel occlusion that may warrant endovascular therapy with clot retrieval. This information is relayed to the local emergency department physicians. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1157311463 ER -