A REDUCTION IN TIME WITH ELECTRONIC MONITORING IN STROKE TRIAL (ARTEMIS Trial).

For the clinical benefit of intravenous thrombolysis (IVT) or intra-arterial
trombectomy (IAT) time is the most crucial factor (time=brain). Reducing the
time between stroke onset en treatment is therefore a major goal. The delay
from first sounding alarm and the start of treatment with IVT/IAT aslo called
the *total system delay* (TSD) dependents very much on logistics and how
various caregivers in this trajectory work together. A promising method to
reduce the TSD is direct visual feedback to caregivers involved with the
patient to encourage them to work more efficiently. In order to investigate
this, however, it is important to have an accurate registration of the TSD,
which is currently lacking.

to reduce the time between sounding alarm by the patient and start of
intravenous thrombolysis and/ or intra-arterial trombectomy in patients with
acute ischemic stroke. In a side-line study we will elucidate factors that
contributed to a delay in calling for help by the patient or bystanders.

First we will set up an electronic and automated way of tracking the TSD. Next
we will start a multiregional, multicentre prospective randomized open
end-point trial to investigate if direct visual feedback to caregivers reduces
the TSD.

The intervention is not aimed at the patient but at the caregivers involved in
acute stroke: direct visual feedback on the actual treatement delays for the
patient they are transferring for IVT/IAT

We expect no buren or risk for the patient. The tracking device is already in
use at the cardiology department of the Leiden University Medical Centre.
Patients have never complaint of any inconvenience so far. The wristband they
recieve up till IVT/IAT has been administred is comparable with the patient
identifying wristband they receive. A formal risk assessment did not show any
interference with existing medical equipment.