Research over the last 20 years has proven that neurological emergencies once felt to be untreatable are, in Fact, treatable. In particular, stroke and anoxic brain injury have been shown to be susceptible to treatment. But, for all the exciting developments in emergency neurology, much remains to be done. Basic questions in emergency neurological disease remain unresolved and effective therapy is not always available to those who might benefit. This application describes a powerful tool for performing emergency neurological research. In developing the Southeast Texas Neurological Emergencies Treatment (SETNET) network, we have three broad objectives: 1. To be part of a large research network able to efficiently recruit patients to test treatments for neurological emergencies of any kind 2. To test these therapies in a variety of ED settings to determine their utility in the """"""""real world"""""""" 3. To increase ED physician ownership of the neurological emergency as an ED problem.
Our specific aims i n setting up our Southeast Texas hub and spokes are: to develop a network of hospitals- urban, suburban and small-town;large and small;academic and community-to efficiently conduct clinical trials of any neurological emergency, to develop a network to communicate with all the ED physicians and neurologists in at our study sites, to develop tools to achieve nursing support for our studies, to develop a system based in EMS and ED triage to identify all prospective patients and notify study coordinators, to train a small team of investigators to evaluate prospective trial participants, obtain consent and begin the trial, to place all study related documents on a secure server which may be accessed by investigators at any of the spoke hospitals, to allow online, real-time data entry, to develop an efficient system to electronically send our data to the clinical coordinating and data management centers, to develop a system to audit data collected, to ensure patient retention throughout the study and to use telemedicine to recruit patients at sites not in the immediate Houston vicinity