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.

Wednesday, January 24, 2018

Mechanical thrombectomy, IV alteplase recommendations updated in new stroke guidelines

You lazy fucking assholes, 'Guidelines' NOT protocols. Can you get any lazier? And you expect to get paid for this crapola?
https://www.healio.com/cardiology/stroke/news/online/%7B8f38493a-36ce-4832-8ef7-5e382f55d24b%7D/mechanical-thrombectomy-iv-alteplase-recommendations-updated-in-new-stroke-guidelines?utm_source=selligent&utm_medium=email&utm_campaign=cardiology%20news&m_bt=592835816269
William J. Powers, MD, FAHA
William J. Powers
IV alteplase may benefit patients with mild strokes, and mechanical thrombectomy may be performed up to 16 hours after the onset of an acute ischemic stroke, according to newly released guidelines published by the American Heart Association and American Stroke Association in Stroke.
“The purpose of these guidelines is very broad,” William J. Powers, MD, FAHA, department chair of stroke and vascular neurology and H. Houston Merritt distinguished professor at University of North Carolina at Chapel Hill and chair of the guidelines writing group, said during a press conference. “They’re not just for physicians. They’re for any health care provider who cares for patients with acute ischemic stroke.”
See Also
In-hospital treatment
According to the guidelines, regional systems of stroke care should be created and include health care facilities for initial emergency care and centers that can perform endovascular stroke treatment. This remains unchanged from the 2015 endovascular guidelines.
Leaders of emergency medical services should develop triage protocols and paradigms to identify and assess patients with a known or suspected stroke. Screening should be done with instruments such as the Los Angeles Prehospital Stroke Screen, FAST scale or Cincinnati Prehospital Stroke Scale.
“We want the patients who do have stroke to get to the hospital as fast as possible,” Powers said. “This means some kind of screening in the field by emergency medical services and ... they need to go to the closest hospital that can adequately evaluate them and give them intravenous [tissue plasminogen activator] or alteplase if they are eligible for it.”
Patients should receive mechanical thrombectomy with a stent retriever if they are aged at least 18 years, have a pre-stroke modified Rankin scale between 0 and 1, have a NIH Stroke Scale score of 6 or greater, have causative occlusion of the internal carotid artery or middle cerebral artery segment 1, have an ASPECTS score of at least 6 and if treatment can start within 6 hours of symptom onset. The guidelines now include those who are ineligible for IV alteplase (Activase, Genentech), as they may benefit from this treatment.
A previous guideline restricted use of mechanical thrombectomy to within 6 hours of ischemic stroke onset, but the new guidelines expand the time window for use depending on certain criteria.
Mechanical thrombectomy is recommended for patients with acute ischemic stroke with large vessel occlusion in the anterior circulation within 6 to 16 hours of symptom onset and who meet DEFUSE-3 or DAWN trial eligibility criteria. It is reasonable for patients to receive this treatment within 16 to 24 hours if they meet other DAWN eligibility criteria.

More pages at link. 

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