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  • Overview
  • Pre-Assessment
  • Activity
    • Webcast
    • FAQ 1
    • FAQ 2
    • FAQ 3
  • Post-Test
  • Evaluation
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Code Stroke: New Approaches to Assess and Treat Acute Ischemic Stroke

Code Stroke: New Approaches to Assess and Treat Acute Ischemic Stroke

Format

Webcast

Time to Complete

1.25 hours

Released

September 8, 2015

Expires

June 30, 2017
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Update

As of January 20, 2017, the content to this activity has been updated to include additional trials that show the benefit of endovascular therapy in stroke.

Maximum Credits

1.25 / AMA PRA Category 1 CreditsTM
1.40 / CE for Nurses (1.40 pharmacology credits)

Accredited Provider

Provided by Boston University School of Medicine (BUSM) in collaboration with Haymarket Medical Education (HME)

Commercial Supporter

Supported by an educational grant from Medtronic.

Partner



In collaboration with Boston Medical Center Stroke and Cerebrovascular Center

Program Description

Newly published guidelines from the American Heart Association/American Stroke Association (AHA/ASA) support the use of endovascular therapy as it has shown benefit in select patients with acute ischemic stroke. In this activity, stroke experts will analyze and interpret recently published data from 5 major randomized clinical trials comparing tPA followed by device removal with intravenous (IV)-tPA alone. The experts will also examine strategies determining how to reduce door-to-needle times, as well as explain popular tools that can be used in the field to assess stroke severity. Finally, this activity will provide neuroimaging recommendations for identifying which patients would benefit from computed tomography angiography (CTA) along with computed tomography (CT) compared with CT alone.

Intended Audience

Emergency medicine physicians, EMS physicians, neurologists, interventional neuroradiologists, interventional neurologists, neurosurgeons, nurses, neurointensive care nurses, radiology technicians, and registered radiology assistants

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Utilize recommended stroke-evaluation time benchmarks to stabilize patients within 60 minutes of arrival in the emergency department, including initial evaluation, assessment, imaging, and laboratory studies
  • Outline current treatments for acute ischemic stroke, including IV thrombolytic therapy with tissue-type plasminogen activator and endovascular therapies, such as intra-arterial thrombolytic therapy and the use of clot-retrieval devices
  • Interpret stroke trial data that have shown the benefit of using neuroimaging to select patients who are most likely to benefit from thrombolytic therapy and the potential benefits of extending the window for thrombolytic therapy beyond the guideline of 3 hours with tPA and newer agents
  • Utilize tools to predict patients' clinical response and risk of hemorrhagic complications following IV thrombolytic therapy
  • Interpret the latest clinical trial data (examples: ESCAPE, EXTEND-IA, REVASCAT, SWIFT PRIME, MR CLEAN, THRACE, and PISTE) evaluating endovascular therapy in the management of acute ischemic stroke and how this data applies to current practice

Conflict Of Interest Disclosure Policy

Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed.

Faculty

Andrew Demchuk, MD
Director, Calgary Stroke Program
Deputy Dept Head, Dept of
Clinical Neurosciences
Heart & Stroke Foundation Chair
in Stroke Research
University of Calgary/Foothills Medical Centre
Calgary, Alberta
Canada

Dr. Demchuk received grant/research support and is on the speaker’s bureau for Covidien/Medtronic.

Edward C. Jauch, MD, MS, FAHA, FACEP
Professor and Director, Division of Emergency Medicine
Professor, Department of Neurosciences
Associate Vice Chair, Research, Department of Medicine
Medical University of South Carolina
Clemson University

Dr. Jauch has received grant/research support from Covidien/Medtronic, Genentech, Penumbra Stroke Center, and Stryker.

Accredited Provider Disclosure

CME Course Director
Thanh Nguyen, MD, FRCPc

Director, Neurointerventional Service
Associate Professor, Neurology, Neurosurgery, Radiology
Boston Medical Center
Boston University School of Medicine
Boston, MA

Dr. Nguyen has received grant/research support from Penumbra, Inc., and is a consultant for Boston Biomedical.

Independent Reviewer
Sherry Chou, MDCM, MMSc

Visiting Associate Professor, Department of Critical Care Medicine
Secondary Appointments in the Departments of Neurology and Neurosurgery
University of Pittsburgh School of Medicine
Pittsburgh, PA

Dr. Chou has nothing to disclose with regard to commercial support.

Judith Welch Clark, RN, BSN, CNE Course Advisor, Patti-Ann Collins, DNP, MSN/MBA, RN, Lead Nurse Planner, Emily Jansen, MPH, and Mike Burk, of Boston University School of Medicine, have nothing to disclose with regard to commercial support.

Planners' and Managers' Disclosures

Susan Basilico, Ruchit Parikh, PharmD, and Priya Wanchoo, MD, of Haymarket Medical Education, have nothing to disclose with regard to commercial support.

Credit

1.25

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

Boston University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

Boston University School of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Registered Radiologist Assistants may use the CME credits earned through the completion of this activity toward their ARRT Continuing Education Requirements.

Credit

1.40

Type

CE for Nurses

Accreditation Statement

Continuing Nursing Education Provider Unit, Boston University School of Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This educational activity has been provided by Continuing Nursing Education Provider Unit, Boston University School of Medicine and jointly provided by Haymarket Medical Education.

Designation Statement

1.40 Contact Hours, all of which are eligible for pharmacology credit.

Disclosure of Unlabeled Use

This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. Covidien, BUSM, Boston Medical Stroke and Cerebrovascular Center, and HME do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Covidien, BUSM, Boston Medical Stroke and Cerebrovascular Center, and HME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Dr. Jauch discusses IV-tPA in the 3 ‐ 4.5 time window.
Dr. Demchuk discusses endovascular treatment for stroke up to 12 hours from symptom onset.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Boston University School of Medicine Disclaimer
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKE NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.

If you have any CME questions, please email the BUSM Continuing Medical Education department at: cme@bu.edu (BUSM Course Code: E.EndoHME15).

Instructions

To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

SYSTEM REQUIREMENTS

Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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