Implementation of Tenecteplase for Acute Ischemic Stroke Treatment

Area of Science:

• Neurology
• Emergency Medicine
• Pharmacology

Background:

• Acute ischemic stroke is a time-sensitive medical emergency requiring prompt intravenous thrombolysis.
• Recent guidelines suggest tenecteplase as an alternative to alteplase for stroke treatment.
• Numerous US centers are adopting tenecteplase for acute ischemic stroke care.

Purpose of the Study:

• To describe a health system's transition from alteplase to tenecteplase for acute ischemic stroke treatment.
• To provide guidance for other institutions implementing this change.
• To highlight key differences between alteplase and tenecteplase for emergency nurses.

Main Methods:

• Health system implemented tenecteplase in 2021.
• Focus on improving door-to-needle time.
• Experience shared to guide institutional change.

Main Results:

• Tenecteplase offers potential for improved door-to-needle times.
• Evidence supports tenecteplase efficacy in acute ischemic stroke.
• Key pharmacologic and logistical differences identified.

Conclusions:

• Emergency nurses play a critical role in acute ischemic stroke patient care.
• Understanding differences between alteplase and tenecteplase is crucial for effective implementation.
• The transition to tenecteplase is supported by growing evidence and potential clinical benefits.