TY - JOUR A1 - Schnabel, Renate B. A1 - Camen, Stephan A1 - Knebel, Fabian A1 - Hagendorff, Andreas A1 - Bavendiek, Udo A1 - Böhm, Michael A1 - Doehner, Wolfram A1 - Endres, Matthias A1 - Gröschel, Klaus A1 - Goette, Andreas A1 - Huttner, Hagen B. A1 - Jensen, Christoph A1 - Kirchhof, Paulus A1 - Korosoglou, Grigorius A1 - Laufs, Ulrich A1 - Liman, Jan A1 - Morbach, Caroline A1 - Navabi, Darius Günther A1 - Neumann-Haefelin, Tobias A1 - Pfeilschifter, Waltraut A1 - Poli, Sven A1 - Rizos, Timolaos A1 - Rolf, Andreas A1 - Röther, Joachim A1 - Schäbitz, Wolf Rüdiger A1 - Steiner, Thorsten A1 - Thomalla, Götz A1 - Wachter, Rolf A1 - Haeusler, Karl Georg T1 - Expert opinion paper on cardiac imaging after ischemic stroke JF - Clinical Research in Cardiology N2 - This expert opinion paper on cardiac imaging after acute ischemic stroke or transient ischemic attack (TIA) includes a statement of the "Heart and Brain" consortium of the German Cardiac Society and the German Stroke Society. The Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork (AFNET) endorsed this paper. Cardiac imaging is a key component of etiological work-up after stroke. Enhanced echocardiographic tools, constantly improving cardiac computer tomography (CT) as well as cardiac magnetic resonance imaging (MRI) offer comprehensive non- or less-invasive cardiac evaluation at the expense of increased costs and/or radiation exposure. Certain imaging findings usually lead to a change in medical secondary stroke prevention or may influence medical treatment. However, there is no proof from a randomized controlled trial (RCT) that the choice of the imaging method influences the prognosis of stroke patients. Summarizing present knowledge, the German Heart and Brain consortium proposes an interdisciplinary, staged standard diagnostic scheme for the detection of risk factors of cardio-embolic stroke. This expert opinion paper aims to give practical advice to physicians who are involved in stroke care. In line with the nature of an expert opinion paper, labeling of classes of recommendations is not provided, since many statements are based on expert opinion, reported case series, and clinical experience. KW - cardiac imaging KW - echocardiography KW - ischemic stroke KW - transient ischemic attack KW - expert opinion KW - magnetic resonance imaging KW - computed tomography Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-266662 SN - 1861-0692 VL - 110 IS - 7 ER - TY - JOUR A1 - Bohmann, Ferdinand O. A1 - Kurka, Natalia A1 - du Mesnil de Rochemont, Richard A1 - Gruber, Katharina A1 - Guenther, Joachim A1 - Rostek, Peter A1 - Rai, Heike A1 - Zickler, Philipp A1 - Ertl, Michael A1 - Berlis, Ansgar A1 - Poli, Sven A1 - Mengel, Annerose A1 - Ringleb, Peter A1 - Nagel, Simon A1 - Pfaff, Johannes A1 - Wollenweber, Frank A. A1 - Kellert, Lars A1 - Herzberg, Moriz A1 - Koehler, Luzie A1 - Haeusler, Karl Georg A1 - Alegiani, Anna A1 - Schubert, Charlotte A1 - Brekenfeld, Caspar A1 - Doppler, Christopher E. J. A1 - Onur, Oezguer A. A1 - Kabbasch, Christoph A1 - Manser, Tanja A1 - Pfeilschifter, Waltraud T1 - Simulation-based training of the rapid evaluation and management of acute stroke (STREAM) — a prospective single-arm multicenter trial JF - Frontiers in Neurology N2 - Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2–3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period. Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the “door-to-needle” time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire. Interventions: We are applying a multi-level intervention in cooperation with three “STREAM multipliers” from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2–3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings. Clinical Trial Registration: STREAM is a registered trial at https://clinicaltrials.gov/ct2/show/NCT03228251. KW - CRM KW - thrombolysis (tPA) KW - stroke KW - emergency care KW - simulation training Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369239 SN - 1664-2295 VL - 10 ER -