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between hospital systems accepting strokes). If you are going to divert a patient from a small <br />remote site where they can get tPA quickly, you need to know an ETA with traffic to the <br />comprehensive site and ensure it is a reasonable wait. Otherwise, they may ethically need tPA <br />locally then helicopter. This specific algorithm of reasonable wait times to the comprehensive <br />site could include average remote site tPA times and would rely on the stroke committees to <br />draft/formalize. <br />All inclusion/exclusion criteria, medications, and basic HPI will be submitted rapidly to the on <br />call neurologist at the destination hospital to a secure tablet and via email like RAPID. A stroke <br />warning page will also be executed to the destination hospital with vehicle ETA. All necessary <br />personnel at the destination hospital will also be contacted such as CT, IR, anesthesia etc. as <br />needed by the on call EMS stroke specialist. <br />We should be live in the next 45 days using the proprietary EMS voice activation video devices <br />and on call stroke specialists with or without the Cabarrus Foundation contract. The implications <br />of the above system certainly go far beyond strokes and include EMS antibiotic administration <br />rapidly for sepsis, antihypertensive med administration, trauma alerts, etc." <br />Attachment number 3 \n <br />F-4 Page 73 <br />