11
2.8. Telemedicine
COR LOE
Recommendations
Prehospital Telemedicine
1 B-R
1. For patients with suspected stroke in the prehospital setting,
telemedicine in the ambulance should be considered, when
feasible, to complement paramedic assessment to identify
candidates for reperfusion interventions.
Teleradiology
1 B-NR
2. For patients with AIS presenting to EDs without in-house
imaging interpretation expertise, teleradiolog y systems
are recommended for timely review of brain imaging,
identification of contraindications to thrombolysis, and
facilitation of IVT decision-making.
Telestroke for rombolytic Decision-Making and Administration
1 B-R
3. For patients with AIS presenting to EDs without acute
neurological expertise, telestroke systems are effective
over usual care by the ED team for IVT decision-making
and optimal thrombolytic delivery including increased
thrombolytic administration and shorter time to delivery.
2a B-NR
4. For patients with AIS treated at hospitals without local stroke
expertise, telestroke is reasonable to reduce short-term mortality.
2a C-LD
5. For patients with AIS treated at hospitals without in-house
stroke expertise or telestroke capabilities, decision-making
support by telephone consultation with a stroke specialist can
be beneficial for IVT decision-making and consideration of
EVT eligibility.
Telestroke in Stroke Systems of Care
1 C-EO
6. Health care institutions, government payers, and vendors
should support the use of telemedicine/telestroke resources
and systems to ensure adequate 24-hour/day and 7-day/week
coverage and care of patients with AIS in a variety of settings.
2b B-NR
7. For patients with AIS presenting to hospitals with telestroke
capability, use of telestroke may be reasonable for triage of
patients who may be eligible for appropriate interfacility
transfer for emergency EVT versus local care.
