Blog Viewer

Mechanical Thrombectomy in the Era of the COVID-19 Pandemic: Emergency Preparedness for Neuroscience Teams

By Currents Editor posted 06-03-2020 08:15

  

Stroke  (04/29/20) doi: 10.1161/STROKEAHA.120.03010

Nguyen, Thanh N.; Abdalkader, Mohamad; Jovin, Tudor G.; et al.

https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.120.030100

 

The Society of Vascular and Interventional Neurology (SVIN) has released a guidance statement on acute ischemic large vessel occlusion strokes in an effort to reduce the transmission of COVID-19 and optimize healthcare resources. The document divides treatment for acute stroke into four phases: prehospital to the emergency department, prethrombectomy, thrombectomy intraprocedure, and post-reperfusion therapy. SVIN’s recommendations include screening every acute stroke patient for symptoms and signs of COVID-19 following local protocols; using remote telestroke technology to obtain history and perform neurological examination, if available; and if there is a positive screening for COVID-19, having the patient wear a surgical mask and immediately placing the individual in a negative pressure room in the emergency department. Additional suggestions include preparing all procedural elements in the room prior to patient arrival; considering low-dose chest computerized tomography (CT) at the same time as the performance of CT head and CT angiography head and neck to facilitate diagnosis of COVID-19; alerting the anesthiology provider early of patient with confirmed or suspected infection; and keeping staff to a minimum during the thrombectomy, both to reduce the risk of exposure and conserve protective equipment. “Every opportunity and detail to recalibrate our acute neurological workflow to protect our frontline healthcare workers, our families, our colleagues, and our patients should be sought, implemented, and adapted to a resource-constrained environment,” the researchers write. “It is incumbent upon us to protect each other so that we are not unknowingly exposed or  spread  to  our  most  vulnerable  patients,  while  at  the  same  time, providing optimal care, patient safety, and access for our patients  with  stroke.”

#LiteratureWatch
#COVID-19

​​
FURTHER READING
Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, ...
By Wade Smith, MD, PhD, FNCS, and Paul Nyquist, MD/MPH, FANA, FCCM, FAAN Introducing the Neurocritical Care Foundation Dear NCS Members, It was wonderful to engage with you all during World Coma Day on March 22. I am proud to lead a society that prioritizes raising awareness of coma as a treatable ...
Bindi Parikh, MD, Neurology Resident, University of Minnesota Christine Yeager, MD, Assistant Professor of Neurology, University of Minnesota     Section Editor Lauren Koffman, DO, MS One Thursday, amidst the peak of the COVID-19 pandemic, Naema had been working from home as a student ...