The following is a summary of “Stroke thrombolysis given by emergency physicians: The time is here,” published in the June 2023 issue of Emergency Medicine by Greenberg, et al.

The core clinical privileges in Emergency Medicine include administering thrombolytic therapy for myocardial infarction and stroke. However, due to a shortage of neurologists, emergency medicine providers have developed a paradigm of relying on neurology specialty consultation for treating acute stroke patients. Studies have shown a shortage of neurologists, and teleneurology and telestroke care have been implemented as a solution, particularly for acute ischemic stroke (AIS) patients.

For a study, researchers presented a model where an Emergency Medicine (EM) Stroke Champion (SC), an EM physician within the Neurologic Emergency Department, takes charge of acute stroke patient care at both comprehensive hub and primary stroke center spoke hospitals. The SCs can independently treat patients with fibrinolytic therapy and provide teleneurology consultation to other emergency physicians caring for acute stroke patients at spoke hospitals. Over nineteen months, the SCs received 457 phone calls for patients meeting stroke alert criteria. Sixteen patients were eligible for IV alteplase treatment, and one experienced hemorrhagic conversion (6.25%)—additionally, sixty-four patients were required to transfer, which the SCs facilitated.

Implementing emergency physician SCs providing teleneurology consultation to their colleagues was feasible and safe. The model has the potential to be extended to all emergency physicians, enabling them to feel confident and comfortable in treating acute stroke patients. By utilizing this approach, hospitals can address the shortage of neurologists and improve the care provided to stroke patients in emergency settings.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001419