“Drip-and-ship” method of IV-tPA by helicopter transportation for acute ischemic stroke patients in the isolated islands in Nagasaki prefecture

一郎, 川原; 隆史, 藤本; 英昭, 高畠; 圭介, 堤; 智憲, 小野; 啓介, 戸田; 啓至, 馬場; 正大, 米倉; 隼人, 高山

doi:10.3995/jstroke.34.69

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…For example, telemedicine support systems for general physicians have been used in some remote islands. 12 However, as we mentioned before, most currently used telestroke systems in Japan were intended to support neurosurgeons or neurologists who do not specialize in stroke management. Therefore, a telestroke system aimed at providing support for general physicians was rare.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a telestroke system for general physicians without a nearby stroke center to shorten the time to intravenous thrombolysis for acute cerebral infarction

Ochiai

Ohta

Kanemaru

et al. 2020

Acute Medicine & Surgery

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Aim We aimed to establish a telestroke system for general physicians in areas without a nearby stroke center and investigate its usefulness for recombinant tissue plasminogen activator (rt‐PA) therapy for patients with acute cerebral infarction. Methods We used a hub and spoke model, in which a hub hospital provided telestroke support to the spoke hospitals in rural areas that were not nearby a stroke center. The telestroke support device enabled the sharing of images and real‐time face‐to‐face discussion with a stroke specialist for diagnosis and treatment. We evaluated the effect of this telestroke system on shortening time to start rt‐PA therapy. Result One hub and three spoke hospitals were selected. From May 2017 to November 2018, seven patients (77.2 ± 6.3 years old) suspected to have acute cerebral infarction were treated at the spoke hospitals via this system, three of whom received intravenous rt‐PA administration by a general physician under telestroke support. If these patients would have been sent via ground ambulance to the nearby stroke center, it would have taken approximately 48 min more to administer rt‐PA. Conclusion Establishment of a telestroke support system for general physicians in areas without a nearby stroke center was useful for promptly performing rt‐PA therapy.

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Section: Discussionmentioning

confidence: 99%

Implementation of a telestroke system for general physicians without a nearby stroke center to shorten the time to intravenous thrombolysis for acute cerebral infarction

Ochiai

Ohta

Kanemaru

et al. 2020

Acute Medicine & Surgery

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“…We use three types of helicopter: helicopter emergency medical services (HEMS), a Maritime Self-Defense Force (MSDF) helicopter, and a firefighting disaster prevention (FDP) helicopter. 4) Use of a helicopter transport system has been reported to be a very safe and beneficial transport method for patients. 5,6) Initiation of IV rt-PA at a regional hospital with subsequent transfer to a specialized stroke center is referred to as the drip and ship (DS) approach.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the Drip and Ship Method in 24-h Helicopter Transportation and Teleradiology for Isolated Islands

Hiu

Ozono

Kawahara

et al. 2019

Neurol. Med. Chir.(Tokyo)

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Our hospital, located on the mainland, serves as a hub center for nine hospitals on the remote islands of Nagasaki Prefecture, Japan. There are no stroke specialists on these islands. We can transfer emergency patients from these islands to our hospital at any time, using a teleradiology system and three types of helicopter transport. We examined the efficacy of the drip and ship (DS) method for treating patients with acute ischemic stroke (AIS) on these islands, in comparison with patients on the mainland. From 2010 to 2017, we reviewed 98 consecutive patients with AIS who received intravenous recombinant tissue plasminogen activator (IV rt-PA) in our hospital or were transported to our hospital after IV rt-PA. Patients were divided into the Islands group (received IV rt-PA on the islands, DS; 31 cases) and the Mainland group (67 cases). The median transport distance from the islands was 112 km. The rate of patients achieving favorable outcomes was 54.8% in the Islands group and 64.2% in the Mainland group, with no significant differences. Multivariate analysis revealed that patients living on isolated islands did not have increased risks of unfavorable outcomes. Endovascular therapy (EVT), as part of the drip, ship, and retrieve method, was performed in 22.6% of patients in the Islands group and EVT in 38.8% of those in the Mainland group. The DS method seems feasible and safe for patients living on isolated islands with the use of 24-h helicopter transportation and teleradiology.

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“Drip-and-ship” method of IV-tPA by helicopter transportation for acute ischemic stroke patients in the isolated islands in Nagasaki prefecture

Cited by 2 publications

References 15 publications

Implementation of a telestroke system for general physicians without a nearby stroke center to shorten the time to intravenous thrombolysis for acute cerebral infarction

Implementation of a telestroke system for general physicians without a nearby stroke center to shorten the time to intravenous thrombolysis for acute cerebral infarction

Efficacy of the Drip and Ship Method in 24-h Helicopter Transportation and Teleradiology for Isolated Islands

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