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Building a "brain attack" team to administer thrombolytic therapy for acute ischemic stroke
M D Hill1, P A Barber, A M Demchuk
1Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Alta. michael.hill@crha-health.ab.ca
Summary
Calgary implemented thrombolytic therapy for acute ischemic stroke before tPA was licensed, improving patient outcomes and reducing treatment times. Further improvements in door-to-needle time and public education are needed.
Area of Science:
- Neurology
- Cardiology
- Emergency Medicine
Background:
- The Calgary Regional Stroke Program proactively organized resources for thrombolytic therapy before tissue plasminogen activator (tPA) approval in Canada.
- Special permission was granted in 1996 to administer intravenous tPA for acute ischemic stroke, with ethical and scientific review board approval.
Purpose of the Study:
- To evaluate the impact of early thrombolytic therapy implementation on patient outcomes for acute ischemic stroke.
- To assess changes in treatment times and adverse event rates following the introduction of tPA.
Main Methods:
- Retrospective analysis of patient data from the Calgary Regional Stroke Program.
- Implementation of organized local resources and protocols for thrombolytic therapy administration.
Main Results:
- Significant improvements in patient outcomes were observed after three years of therapy implementation.
- Shorter times from symptom onset to treatment were achieved.
- Adverse event rates were found to be acceptable.
Conclusions:
- The early organization of resources and implementation of thrombolytic therapy were effective in improving acute ischemic stroke care.
- Continued focus on reducing door-to-needle time and enhancing public awareness of stroke symptoms is recommended.