Emergency medicine residents in the implementation of thrombolysis for acute ischemic stroke

Traditionally, neurologists have been in charge of thrombolytic treatment of ischemic stroke. In 2013, emergency medicine residents started working in the frontline at the Central Hospital of Central Finland (CHCF). They were trained to evaluate and give thrombolytic treatment to acute ischemic stroke patients out of hours, with the possibility of consulting a neurologist.

Retrospective study of acute stroke patients in CHCF, who received thrombolytic therapy during 2012 and 2014. In 2012 thrombolytic treatment was initiated by neurologists only, In 2014 emergency medicine registrars initiated thrombolytic therapy out of hours.

The annual number of tissue plasminogen activator treatment (tPA) increased and door-to needle time significantly decreased from 2012 to 2014. There were no significant differences in complications and overall functional capacity at 3 months.

This study indicated that training of emergency medicine physicians to give thrombolytic treatment to acute ischemic stroke is feasible and may shorten in-hospital delays.