Deans' stroke musings: Pace of Progress in Stroke Thrombolysis Are Hospitals Running To Stand Still?

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 17, 2017

Pace of Progress in Stroke Thrombolysis Are Hospitals Running To Stand Still?

This is totally pathetic. The goal should be negative DTN time. With an objective diagnosis in the ambulance with no neurologist needed you should be able to deliver tPA before you get to the hospital. If that is not your goal then get the fuck out of the way and let actual leaders get that done.
http://circoutcomes.ahajournals.org/content/10/1/e003438?etoc=

Scott J. Mendelson,

https://doi.org/10.1161/CIRCOUTCOMES.116.003438

Circulation: Cardiovascular Quality and Outcomes. 2017;10:e003438

Originally published January 17, 2017

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Stroke is a time-sensitive medical emergency and a leading cause of disability in the United States. Therapies to halt and even reverse ischemic injury to the brain, such as intravenous tissue-type plasminogen activator (tPA), are available, but the systems to deliver them rapidly have not been optimized to ensure timely treatment of as many eligible patients as possible. Although ≈40 000 to 50 000 acute ischemic stroke patients per year receive tPA,^1,2 benefits from the drug are not simply related to receiving it or not but rather are closely linked to time from onset to treatment.^3,4 Delays to treatment lead to more disability because every additional 5 minutes is tantamount to the permanent loss of nearly 10 million brain cells.⁵ National guidelines and quality measures have, therefore, emphasized speed of stroke thrombolysis, focusing on the time between patient arrival to the hospital and tPA administration, also known as door-to-needle (DTN) time.^6,7 Alarmingly, recommendations that hospitals evaluate acute ischemic stroke patients and administer tPA within 60 minutes(Wrong goal)of a patient’s arrival to the emergency department have existed since the original National Institutes of Neurological Disorders and Stroke tPA trial.⁸ Despite this, as the first decade of the new millennium closed, US hospitals were not meeting this goal in a majority of patients.