The door-to-needle time is an important goal to reduce the time to treatment in intravenous thrombolysis. Objective Analyze if the inclusion of an exclusive thrombolytic bed reduces the door-to-needle time. Method One hundred and fifty patients admitted for neurological evaluation with ischemic stroke were separated in two groups: in the first, patients were admitted in the Emergency Room for intravenous thrombolysis (ER Group); in the second, patients were admitted in an exclusive thrombolytic bed in the general neurology ward (TB Group). Results Sixty-eight (86.0%) patients from TB Group were treated in the first 60 minutes of arrival as compared to 48 (67.6%) in the ER Group (p = 0.011). Conclusion The introduction of a thrombolytic bed in a general hospital setting can markedly reduce the door-to-needle time, allowing more than 85% of patients to be treated within the first hour of admission.
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http://dx.doi.org/10.1590/0004-282X20160048 | DOI Listing |
J Neurol
January 2025
Neurology, Cantonal Hospital of Baden, Baden, Switzerland.
Background: Correct identification of those patients presenting with an acute vestibular syndrome (AVS) or an acute imbalance syndrome (AIS) that have underlying posterior-circulation stroke (PCS) and thus may benefit from revascularization (intravenous thrombolysis (IVT), endovascular therapy (EVT)) is important. Treatment guidelines for AVS/AIS patients are lacking. We reviewed the evidence on acute treatment strategies in AVS/AIS focusing on predictors for IVT/EVT and outcome.
View Article and Find Full Text PDFJ Neurol Sci
January 2025
Department of Industrial Engineering, Faculty of Engineering, Dalhousie University, Halifax, Canada; Division of Neurology, Department of Medicine, Dalhousie University, Halifax, Canada; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada.
Background: Fast treatment is crucial for ischemic stroke patients; the probability of good patient outcomes increases with faster treatment. Treatment times can be improved by making changes to the treatment process. However, it is challenging to identify the benefits of changes prior to implementation.
View Article and Find Full Text PDFJ Stroke Cerebrovasc Dis
December 2024
Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:
Introduction: Multidisciplinary stroke teams, including a stroke nurse, prove effective in delivering optimal acute ischemic stroke (AIS) management. This systematic review and meta-analysis critically synthesize existing studies to assess the impact of stroke nurse involvement on treatment time benchmarks and patient outcomes.
Method: Data from various databases constituted the primary sources of literature, and the risk of bias and article quality were evaluated using relevant tools.
Int J Nurs Sci
November 2024
Department of Emergency Medicine, Zhejiang Hospital, Hangzhou, Zhejiang Province, China.
Objective: Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes. This study investigated whether optimizing intravenous thrombolytic (IVT) therapy strategies for stroke could reduce treatment delays.
Methods: To reduce delays in IVT therapy for ischemic stroke, a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou, Zhejiang Province, from June 2021 to August 2023, which included developing a timeline process management system, forming a nurse-led stroke process management team, providing homogeneous training, standardizing the IVT therapy process for ischemic stroke, and introducing an incentive policy.
Hosp Pract (1995)
December 2024
Clinical Services Group, HCA Healthcare, Nashville, TN, USA.
Objective: Pharmacologic thrombolytic treatment for acute ischemic stroke has primarily been managed by intravenous alteplase. Tenecteplase is a variant that has been shown to be non-inferior to alteplase in clinical trials. In this study, we present a real-world assessment of patient outcomes with the facility-wide transition to the use of tenecteplase versus altepase for acute ischemic stroke in a large system of community hospitals in the United States.
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