Introduction: Timely diagnosis of pediatric stroke is challenging, yet early recognition is critical to guide treatment, including neuroprotective measures, antithrombotic therapy, and consideration of reperfusion therapies in select cases. Children often present to community hospitals without pediatric neurology expertise, leading to delays in recognition and expert evaluation. To address this gap, we implemented a pediatric telestroke program across a regional healthcare system to enable rapid consultation and standardized pathways. Methods: Implementation involved collaboration among pediatric neurologists, emergency physicians, pharmacists, pediatric telehealth experts, and transfer center staff. Key steps included: (1) leveraging existing adult telestroke technology to support pediatric consultations; (2) training pediatric neurologists in telestroke workflows and acute stroke therapies; and (3) outreach to community providers, including pediatricians, emergency physicians, and nurses. Results: Since launch in September 2024, pediatric telestroke services have expanded to 25 hospitals, providing broad regional access to pediatric stroke expertise. Implementation created major opportunities for education, with extensive materials and presentations developed and outreach increasing familiarity with pediatric stroke among frontline providers. A system-wide pediatric stroke code was established, improving clarity and timeliness of response when stroke is suspected. A larger cohort of pediatric neurologists was trained in telestroke delivery and acute therapy use. Early lessons learned included the critical importance of pediatric-specific transfer center coordination, the unexpectedly large educational footprint generated, and a culture shift toward recognizing pediatric stroke as an emergency. Outreach consistently revealed comments such as, “I didn’t know kids have strokes,” underscoring the program’s impact on awareness. Conclusion: Implementation of a pediatric telestroke network across 25 hospitals is feasible and has enhanced regional awareness, education, and system readiness. Future work should refine consultation criteria, evaluate outcomes such as time to intervention and resource utilization, expand to additional hospitals, and ensure both adequate pediatric stroke expertise and financial sustainability to support long-term physician coverage.
Pabst et al. (Thu,) studied this question.