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Can Emergency Department Physicians Safely and Effectively Initiate Thrombolysis for Acute Ischemic Stroke? Neurol 55:1801-1805, Akins,P.T.,et al, 2000 See this aricle in Pubmed Article Abstract Excellent functional recovery measured by a Modified Rankin score of 0 to 1 (42%), symptomatic intracerebral hemorrhages (7%), and mortality (16.3%) were similar to those reported by National Institute of Neurological Disorders and Stroke (3 9%, 7.7%, 17.3%). After initial screening by an ED physician, 20 patients were directly examined by a stroke neurologist who then prescribed tPA. Twenty-three patients received tPA prescribed by an ED physician after telephone consultation with a neurol ogist and review of the head CT by a radiologist. Door-to-needle time was similar. Protocol deviations were much higher when ED physicians prescribed the tPA compared to when neurologists did similar. Protocol deviations were reduced with staff educati on. The clinical results of the National Institute of Neurological Disorders and Stroke tPA Stroke Trial were replicated in this small series of patients treated in a community setting. Outcomes were similar whether the prescribing physician was a neuro logist or an ED physician.

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(click to filter results - removes previous filter) cerebrovascular accident,acute management of cerebrovascular accident,thrombolytic agents in treatment emergency physician fibrinolytic agents tissue plasminogen activator,intravenous treatment of neurologic disorder

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