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Edward P. Sloan, MD, MPH FERNE/EMA Session: FERNE/EMA Session: Treating Ischemic Stroke Treating Ischemic Stroke Patients Using a Patients Using a 3 to 4.5 Hour tPA Window 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

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Page 1: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH

FERNE/EMA Session: FERNE/EMA Session:

Treating Ischemic Stroke Treating Ischemic Stroke Patients Using a Patients Using a

3 to 4.5 Hour tPA Window3 to 4.5 Hour tPA Window

Page 2: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH

2009 EMA Advanced Emergency & Acute Care Medicine

Conference

Atlantic City, NJAtlantic City, NJSeptember 22, 2009September 22, 2009

Page 3: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Edward P. Sloan, MD, MPH

Professor

Department of Emergency MedicineUniversity of Illinois at Chicago

Chicago, Illinois

Page 4: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Attending PhysicianEmergency Medicine

University of Illinois HospitalSwedish American Belvidere Hospital

Chicago, IL

Page 5: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

DisclosuresDisclosuresFERNE Chairman and PresidentFERNE Chairman and President

FERNE grants by industryFERNE grants by industry

Participation on industry-sponsored Participation on industry-sponsored advisory boards and as lecturer in advisory boards and as lecturer in programs supported by industryprograms supported by industry

ACEP Clinical Policy CommitteeACEP Clinical Policy Committee

2009 MEMC Educational activities 2009 MEMC Educational activities supported by an Educational Grant supported by an Educational Grant from Alexza Pharmaceuticals from Alexza Pharmaceuticals

Page 6: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

www.ferne.orgwww.ferne.org

Page 7: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

OverviewOverview

Mission Statement PreambleMission Statement Preamble

The Foundation for the Education and The Foundation for the Education and Research in Neurological Emergencies is Research in Neurological Emergencies is an independent not-for-profit organization an independent not-for-profit organization committed to the following principles:committed to the following principles:

Page 8: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

OverviewOverview

Mission Statement PrinciplesMission Statement Principles

• Patients with neurologic emergencies deserve Patients with neurologic emergencies deserve quality emergency care.quality emergency care.

• The emergency care for neurologic emergencies The emergency care for neurologic emergencies can be enhanced through quality scientific can be enhanced through quality scientific research.research.

• Emergency medical care providers can provide Emergency medical care providers can provide optimal medical care for patients with optimal medical care for patients with neurological emergencies through participation neurological emergencies through participation in quality medical education that highlights in quality medical education that highlights state-of-the-art neurologic care.state-of-the-art neurologic care.

Page 9: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

Industry Collaborators Industry Collaborators

Abbott LaboratoriesAbbott Laboratories

Adam Williams InitiativeAdam Williams Initiative

Alexza PharmaceuticalsAlexza Pharmaceuticals

AstraZenecaAstraZeneca

Boston ScientificBoston Scientific

Bristol Myers SquibbBristol Myers Squibb

Concentric MedicalConcentric Medical

Eisai Inc.Eisai Inc.

EB MedicineEB Medicine

EKR Therapeutics, Inc.EKR Therapeutics, Inc.

EMAEMA

GenentechGenentech

GTEGTEJanssen PharmaceuticalJanssen PharmaceuticalNovo Nordisk, Inc.Novo Nordisk, Inc.The Medicines CompanyThe Medicines CompanyOrtho-McNeil Pharmaceutical, Ortho-McNeil Pharmaceutical,

Inc.Inc.Parke-DavisParke-DavisPfizerPfizerRoche PharmaceuticalRoche PharmaceuticalUCB Pharma, Inc.UCB Pharma, Inc.

Page 10: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

Academic CollaborationsAcademic CollaborationsAmerican Academy of Emergency Medicine (AAEM)American Academy of Emergency Medicine (AAEM)American Stroke Association (ASA)American Stroke Association (ASA)American College of Emergency Physicians (ACEP)American College of Emergency Physicians (ACEP)Emergency Medicine Foundation (EMF)Emergency Medicine Foundation (EMF)Emergency Medicine Residents’ Association (EMRA)Emergency Medicine Residents’ Association (EMRA)European Society for Emergency Medicine (EuSEM)European Society for Emergency Medicine (EuSEM)Illinois College of Emergency Physicians (ICEP)Illinois College of Emergency Physicians (ICEP)International Brain Injury Association (IBIA)International Brain Injury Association (IBIA)Mount Sinai School of Medicine, NY (MSSM)Mount Sinai School of Medicine, NY (MSSM)National Institute of Neurological Disorders and Stroke (NINDS)National Institute of Neurological Disorders and Stroke (NINDS)Resuscitative Hypothermia Academic Industry Roundtable (RHAIR) Resuscitative Hypothermia Academic Industry Roundtable (RHAIR) Society for Academic Emergency Medicine Society for Academic Emergency Medicine (SAEM)(SAEM)

Page 11: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

Board Chairman and PresidentBoard Chairman and President

Edward P. Sloan, MD, MPH, FACEPEdward P. Sloan, MD, MPH, FACEP  ProfessorProfessorDepartment of Emergency Medicine,Department of Emergency Medicine,University of Illinois School of MedicineUniversity of Illinois School of Medicine

Attending PhysicianAttending PhysicianEmergency Medical Services,Emergency Medical Services,University of Illinois Hospital, ChicagoUniversity of Illinois Hospital, ChicagoOur Lady of the Resurrection Hospital, ChicagoOur Lady of the Resurrection Hospital, Chicago

Page 12: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Andy Jagoda, MD, FACEPAndy Jagoda, MD, FACEP - - TreasurerTreasurer

Professor and ChairProfessor and ChairMedical DirectorMedical DirectorDepartment of Emergency Medicine,Department of Emergency Medicine,Mount Sinai School of Medicine, New York, NYMount Sinai School of Medicine, New York, NY

Attending PhysicianAttending PhysicianDepartment of Emergency Medicine,Department of Emergency Medicine,Mount Sinai School of Medicine, New York, NYMount Sinai School of Medicine, New York, NY

J. Steven Huff, MD, FACEPJ. Steven Huff, MD, FACEP - - SecretarySecretary

Associate ProfessorAssociate ProfessorEmergency Medicine and Neurology,Emergency Medicine and Neurology,University of VirginiaUniversity of Virginia

Attending PhysicianAttending PhysicianDepartment of Emergency Medicine,Department of Emergency Medicine,University of VirginiaUniversity of Virginia

AdministrativeAdministrative

Executive Board MembersExecutive Board Members

Page 13: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

ExecutiveExecutive Board MembersBoard MembersWilliam G. Barsan, MD, FACEPWilliam G. Barsan, MD, FACEP

Professor and ChairProfessor and ChairDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Michigan, Ann ArborUniversity of Michigan, Ann Arbor

Attending PhysicianAttending PhysicianDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Michigan, Ann ArborUniversity of Michigan, Ann Arbor

E. Bradshaw Bunney, MD, FACEPE. Bradshaw Bunney, MD, FACEP  Associate ProfessorAssociate ProfessorDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Illinois School of MedicineUniversity of Illinois School of Medicine

Attending PhysicianAttending PhysicianEmergency Medical ServiceEmergency Medical ServiceUniversity of Illinois HospitalUniversity of Illinois HospitalOur Lady of the Resurrection Hospital, Our Lady of the Resurrection Hospital, ChicagoChicago

Page 14: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

ExecutiveExecutive Board MembersBoard Members

Scott M. Silvers, MD, FACEPScott M. Silvers, MD, FACEP

Assistant Professor of MedicineAssistant Professor of MedicineMayo Medical SchoolMayo Medical SchoolRochester, Minnesota Rochester, Minnesota

ConsultantConsultantChair, Emergency Medicine EducationChair, Emergency Medicine EducationDivision of Emergency MedicineDivision of Emergency MedicineMayo Clinic, JacksonvilleMayo Clinic, Jacksonville

Sydney Starkman, MD, FACEPSydney Starkman, MD, FACEP

Professor of Emergency Medicine and Professor of Emergency Medicine and NeurologyNeurologyDirector, Emergency Stroke ProgramDirector, Emergency Stroke ProgramUniversity of California Los AngelesUniversity of California Los AngelesLos Angeles California Los Angeles California

Page 15: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

AdministrativeAdministrative

ExecutiveExecutive Board MembersBoard Members

Heather Prendergast, MDHeather Prendergast, MD

Associate Professor of Emergency MedicineAssociate Professor of Emergency MedicineUniversity of IllinoisUniversity of IllinoisChicago, ILChicago, IL

Jonathan Edlow, MDJonathan Edlow, MD

Associate Professor of Emergency MedicineAssociate Professor of Emergency MedicineBeth Israel HospitalBeth Israel HospitalBoston, MA Boston, MA

Page 16: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

30 Members30 MembersEmergency Medicine PhysiciansEmergency Medicine PhysiciansProvides input regarding needs and Provides input regarding needs and

future directionsfuture directionsAdvisory board last convened May Advisory board last convened May

20042004Insights into FERNE priorities and Insights into FERNE priorities and

educational needseducational needs

AdministrativeAdministrative

Extended AdvisoryExtended Advisory BoardBoard

Page 17: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Case-based LearningCase-based Learning

Uniform contentUniform contentCase presentationCase presentationKey Learning PointsKey Learning PointsIntroduction, discussion of the clinical disease Introduction, discussion of the clinical disease

statestateOptimal ED management strategiesOptimal ED management strategiesPatient outcomePatient outcomeReferencesReferencesAnnotated bibliographyAnnotated bibliographyQuestions and answersQuestions and answers

Page 18: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

CMECME

CME available through the CME available through the

EB Medicine (ebmedicine.net)EB Medicine (ebmedicine.net)

Available for all FERNE educational Available for all FERNE educational meetingsmeetings

Free for all course attendeesFree for all course attendees

Page 19: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Page 20: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Page 21: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Other Educational MaterialsOther Educational Materials

Acute Stroke MaterialsAcute Stroke Materials

Developed a Handbook and Developed a Handbook and Companion CD RomCompanion CD Rom

Published Spring 2004Published Spring 2004

Collaboration included Collaboration included American Stroke American Stroke

Association and France Association and France FoundationFoundation

Page 22: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

SupplementsSupplements

Planned Seizure PublicationPlanned Seizure Publication

Emergency Medicine Clinics Emergency Medicine Clinics 20102010

Comprehensive state-of-the-art Seizure DataComprehensive state-of-the-art Seizure Data

15 Manuscripts total15 Manuscripts total

Page 23: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Meeting Attendance and EvaluationsMeeting Attendance and Evaluations

82 FERNE meetings82 FERNE meetings

~ 460 Educational Lectures, 14 Research Lectures~ 460 Educational Lectures, 14 Research Lectures

~ 188 Speakers~ 188 Speakers

~ 5850 physicians in attendance~ 5850 physicians in attendance

~ 11,000 contact hours~ 11,000 contact hours

Evaluated as excellent or good by 97% of learnersEvaluated as excellent or good by 97% of learners

Page 24: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Web-based Learning: WebsiteWeb-based Learning: Website

www.ferne.orgwww.ferne.org

Page 25: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Web-based Learning: EMedHome.comWeb-based Learning: EMedHome.com

www.ferne.orgwww.ferne.org

• FERNE generated contentFERNE generated content

• CME can be obtained via EMedHome websiteCME can be obtained via EMedHome website• Slides and audioSlides and audio

Page 26: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Web-based Learning: Video SlideshowsWeb-based Learning: Video Slideshows

• Audio, video and slide contentAudio, video and slide content• Able to access individual slides, specific contentAble to access individual slides, specific content• MS Producer, viewable with Windows Media PlayerMS Producer, viewable with Windows Media Player

Page 27: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Web-based Learning: Slide LecturesWeb-based Learning: Slide Lectures

Download or view online

Page 28: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Handheld Software: HandiStroke RxHandheld Software: HandiStroke Rx

HANDi Stroke Rx Available freefrom www.ferne.org

• Written at Mount Sinai, New York• Funded by a FERNE grant• NIH Stroke Scale• tPA Inclusion/Exclusion criteria• tPA dosage calculator• Continuation of care orders

Page 29: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

EducationEducation

Handheld Software: Handheld Software: SeizureStat©

SeizureStat© Available freefrom www.ferne.org

• Written at University of Illinois, Chicago

• Funded by FERNE • Written materials• Urgent SE protocol• Information on 10 urgent meds

Page 30: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

ResearchResearch

Directed Neurological Emergencies Research GrantDirected Neurological Emergencies Research Grant

• Up to $ 50,000 per Grant• $300,000 awarded with EMF support• Promotes new knowledge relating to the

diagnosis and management of neurological emergencies in the medical community

• Directed to researchers in established emergency medicine research program

• One directed research grant per institution, per cycle, is awarded

Page 31: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

ResearchResearch

Directed Neurological Emergencies Research GrantDirected Neurological Emergencies Research Grant

•Christopher Barton, MD•UCSF

•Emergency Department Assessment of Secondary Brain Insults in ICH

•Jane Brice, MD, MPH•UCSF

•Stat 911: Stroke Assessment Tool for 911

Page 32: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

ResearchResearch

Directed Neurological Emergencies Research GrantDirected Neurological Emergencies Research Grant

•Andrew W. Asimos, MD•Carolinas Medical Center•A Prospective Validation Study of the ABCD Score and Kaiser Criteria for Short-term Stroke Risk after ED Diagnosis of TIA

•Michael Ross, MD•William Beaumont Hospital Research Institute•The Emergency Department Transient Ischemic Attack Accelerated Diagnostic Protocol

Page 33: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

ResearchResearch

Seed Grants / Unsolicited ProposalsSeed Grants / Unsolicited Proposals

• Up to $5,000 grants, $25,000 total

• Promote new research

• Help secure future funding

• Identify the support source

• Specific area of interest

• Available for all EM practitioners

Page 34: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Opportunities For InvolvementOpportunities For Involvement

How You Can Become InvolvedHow You Can Become Involved

• Development of new cases• Become a speaker• Tell us about your preferred:

• Symposia, content, venues• Learning methods • Research grants

• Develop technology based applications

• Contact us: [email protected]

Page 35: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

www.ferne.orgwww.ferne.orgCheck It Out !Check It Out !

Page 36: Edward P. Sloan, MD, MPH FERNE/EMA Session: Treating Ischemic Stroke Patients Using a 3 to 4.5 Hour tPA Window

Edward P. Sloan, MD, MPH, FACEP

Questions?Questions?

www.FERNE.org

[email protected]

ferne_ema_2009_sloan_intro_092209_final04/18/23 19:22