Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Clot Retraction and Fibrinolysis
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Pulmonary Embolism III: Nursing Management
You might also read
Related Articles
Articles linked to this work by shared authors, journal, and citation graph.
Author Response: Factors Requiring Improvement for Timely and Effective Treatment of Acute Stroke.
Stumbling Blocks to Stroke Thrombolysis: An Indian Perspective.
Electroencephalography and Bispectral Index Reactivity to Predict Outcome in Unconscious Patients with Acute Severe Traumatic Brain Injury: A Prospective Observational Study.
NETosis Markers, Such as Citrullinated Histones, Myeloperoxidase, and Elastase, should not be Recommended as Predictors of COVID-19 Severity.
Author Response: NETosis Markers such as Citrullinated Histones Myeloperoxidase and Elastase should not be Recommended as Predictors of COVID-19 Severity.
Artificial Intelligence Literacy in Intensive Care: From Algorithmic Fluency to Clinical Accountability.
Efficacy of Noninvasive Ventilation Compared with Invasive Mechanical Ventilation in Cardiogenic Shock: A Systematic Review and Meta-analysis.
Network Meta-analysis of the Efficacy of Different Music Therapy Interventions for Delirium in Adult Intensive Care Unit Patients.
Related Experiment Video
Updated: Aug 8, 2025

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Stroke Thrombolysis: Beating the Clock.
Aviral Shah1, Arundhati Diwan2
1Department of Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Faster thrombolysis for acute ischemic stroke is vital. This study found that while most patients received neuroimaging within 60 minutes, door-to-needle times often exceeded 90 minutes, indicating a need for improved stroke care protocols.
Area of Science:
- Neurology
- Emergency Medicine
- Radiology
Background:
- Recombinant tissue plasminogen activator (rtPA) is a key treatment for acute ischemic stroke.
- Reducing door-to-imaging (DIT) and door-to-needle (DTN) times is critical for improving patient outcomes.
- This study assesses DIT and DTN in rtPA-treated stroke patients.
Purpose of the Study:
- To evaluate the door-to-imaging time (DIT) and door-to-needle (DTN) intervals for patients receiving rtPA for acute ischemic stroke.
- To identify potential delays in stroke care pathways at a tertiary care center.
Main Methods:
- A cross-sectional observational study was conducted over 18 months.
- Data included 252 acute ischemic stroke patients, with 52 undergoing rtPA thrombolysis.
- Time intervals from arrival to neuroimaging and thrombolysis initiation were recorded.
Main Results:
- Only 10 patients had neuroimaging within 30 minutes; 38 had it within 30-60 minutes.
- The majority of thrombolysed patients (31) had DTN times between 61-90 minutes.
- DTN times for 5 patients exceeded 180 minutes, indicating significant delays.
Conclusions:
- Most patients received neuroimaging within 60 minutes and thrombolysis within 60-90 minutes.
- Achieved time intervals did not meet recommended ideal times for stroke thrombolysis.
- Further streamlining of stroke management protocols is necessary, even in tertiary care settings.

