Abstract Details

Title The Feasibility of iPad Technology for Remote Acute Ischemic Stroke Assessment

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P05 - (-)

Poster/Presentation
Number 203

Objective

Background BACKGROUND: Telestroke, the use of telecommunication technology in the diagnosis and treatment of acute ischemic stroke, is a level I, class A recommendation in the absence of a neurologist. This technology aims to improve access to stroke expertise, especially at rural hospitals, in order to increase the administration of tissue plasminogen activator (tPA) - the only FDA-approved treatment for acute ischemic stroke. Expense, maintenance, firewall settings, and hardware issues limit the incorporation of telestroke at many hospitals. This study evaluated the feasibility of remote National Institutes of Health Stroke Scale (NIHSS) assessments performed using iPad technology as compared to in-person NIHSS assessments with the hope of adding a new, technologically simple, low maintenance, and cost-efficient telestroke option.

Design/Methods DESIGN/METHODS: 15 patients were assessed using the NIHSS via an iPad anchored to the bedside table. A bedside neurologist and a remote neurologist were aided in the performance of the NIHSS by a bedside assistant. Each NIHSS assessment was led by the remote neurologist who had a second iPad. After the initial examination, the remote neurologist came to the patient's bedside to perform an in-person NIHSS. It was determined that the comparison of the two scores by the same neurologist, in person and via iPad, best evaluated the feasibility of using iPad technology in telestroke.

Results RESULTS: The overall matched ratings were 90.0% (189/210) demonstrating good agreement in level of consciousness, gaze, visual, motor arm, motor leg, ataxia, sensory, language, dysarthria, and extinction and moderate agreement in facial palsy. Based on the findings, a set of instructions was developed for the bedside assistant to improve the accuracy of remote NIHSS scoring.

Conclusions CONCLUSIONS: Our results support the feasibility of iPad technology as an inexpensive and reliable telestroke option.

Authors/Disclosures
Sophia Binz PRESENTER	No disclosure on file
Rakesh Khatri, MD, FAAN	Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Alpha insight . Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Survey company .
Jeanne Carroll, RN	Ms. Carroll has nothing to disclose.
	No disclosure on file
	No disclosure on file
Fen-Lei F. Chang, MD, PhD (Parkview Neuroscience)	Dr. Chang has nothing to disclose.

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