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Prehospital Thrombolysis: A Manual from Berlin
05:52

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Published on: November 26, 2013

Does a 'code stroke' rapid access protocol decrease door-to-needle time for thrombolysis?

Y J Tai1, L Weir, P Hand

  • 1Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Internal Medicine Journal
|January 4, 2012
PubMed
Summary
This summary is machine-generated.

Implementing a "code stroke" protocol significantly reduced door-to-needle times for acute ischemic stroke patients, increasing the use of intravenous tissue plasminogen activator (IVtPA) and improving treatment efficiency.

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Healthcare Systems

Background:

  • Timely administration of intravenous tissue plasminogen activator (IVtPA) is crucial for acute ischemic stroke outcomes.
  • Coordinated hospital systems are essential to minimize delays in IVtPA treatment.

Purpose of the Study:

  • To evaluate the effectiveness of the 'code stroke' rapid access protocol implemented in July 2007.
  • To assess the protocol's impact on door-to-needle time and IVtPA utilization.

Main Methods:

  • Retrospective analysis of patients receiving IVtPA between January 2003-June 2007 (pre-code stroke) and July 2007-December 2010 (code stroke).
  • Collected data included demographics, stroke onset, emergency department presentation, neuroimaging, and thrombolysis times.
  • Compared door-to-needle times and IVtPA usage rates between the two eras.

Main Results:

  • The 'code stroke' protocol reduced median door-to-needle time by 18 minutes (90 min vs. 72 min, P < 0.001).
  • IVtPA usage increased from 3.9% in 2004 to 17.3% in 2010.
  • Data from 98 'pre-code stroke' and 189 'code stroke' patients were analyzed.

Conclusions:

  • The 'code stroke' rapid access protocol effectively decreased door-to-needle time.
  • The protocol may have contributed to the observed increase in IVtPA usage for acute ischemic stroke.