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Stroke thrombolysis given by emergency physicians cuts in-hospital delays
significantly immediately after implementing a new treatment protocol
#MMPMID27067664
Heikkilä I
; Kuusisto H
; Stolberg A
; Palomäki A
Scand J Trauma Resusc Emerg Med
2016[Apr]; 24
(?): 46
PMID27067664
show ga
BACKGROUND: Tissue plasminogen activator (tPA) treatment for acute ischaemic
stroke (AIS) should be given as soon as possible, preferably within 60 min after
arrival at hospital. There is great variation in door-to-needle times (DNTs)
internationally, nationally and even within the same hospital. Various strategies
for improving treatment delays have been presented. The role of emergency
physicians (EPs) in treating AIS has been under discussion in recent years.
Emergency Medicine (EM) officially became a specialty in Finland in 2013.
Practical education of EPs in Kanta-Häme Central Hospital began in October 2012,
together with reorganization of the in-hospital treatment path for AIS patients.
The main change was shifting the on-call duty regarding stroke patients from
internists or neurologists to EPs after the third quarter of 2013. METHODS: This
was a retrospective study. The data, concerning the characteristics of
tPA-treated patients, DNTs and onset-to-treatment times (OTTs) was collected from
electronic and paper records. The period studied was 1 year before and 1 year
during reorganization, i.e. 2012 and 2013. RESULTS: During the study period a
total of 64 tPA treatments were given, 31 before and 33 during reorganization.
The median DNT was 54 min in 2012, while it was 28 min in 2013 (p?
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