New research finds hospitals administer wrong dose of drugs to stroke patients in emergency departments by failing to weigh them

I have no clue if I was weighed before I got tPA. YOU will need to scream at your Emergency room doctor, 'Are you giving me the right tPA dose based upon my weight?' Is this part of the problem that tPA only works completely 12% of the time?
 
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A new study has revealed stroke patients receiving emergency clot busting drugs, the correct dose of which depends on the patient’s weight, may be receiving the wrong dose because the UK (and much of Europe) does not weigh patients prior to its administration.
The research, which is published in Stroke today (10 November), was carried out by the Institute of Cardiovascular Research at Royal Holloway, University of London and St Peters Hospital in Chertsey and reveals errors were being made in the dosage because clinicians were poor at guessing the weight of patients, particularly the heaviest patients (weighing over 80kg) irrespective of age, gender or presence of other diseases.
Overall, approximately 20% of patients received an incorrect dose (about 11% too little and 8% too much). Around 1 in 5 of the heaviest patients, received a 10% incorrect (usually too little) dose of the clot busting drug. At discharge these patients had on average 10% poorer outcome.
Those patients who had been accurately dosed were seen to have the greatest functional improvement at discharge.
Lead researcher Professor Pankaj Sharma from the Institute of Cardiovascular Research at Royal Holloway, said: “Our study has revealed that patients are being given the wrong dose of up to 10% of the amount they should receive which is resulting in poorer outcomes. This was the case in 1 in 5 of the heaviest patients, which made up a third of the studied population.
If we were to extrapolate this data to the approximately 150,000 individuals that suffer a stroke annually in the UK then it would mean around 10,000 stroke victims per year are receiving the wrong dose, potentially impacting on their final functional outcome.”
The researchers have made a recommendation that all emergency/A&E departments in the UK have at least one automatic weighing bed and that this should be mandated across the NHS.
A simple automatic weighing accessory for a hospital bed can cost as little as a few hundred pounds but potentially save the NHS millions of pounds in terms of better stroke outcome and reduced morbidity.
Professor Sharma added: “I would struggle to think of an alternative intervention for stroke that would benefit so many patients, in so short a time, for so little money.”

Attached files

• Impact of a Stroke on the brain
  

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• Full bibliographic informationEstimating Weight of Patients With Acute Stroke When Dosing for Thrombolysis, Tom Barrow, BSc; Muhammad S. Khan, MSc; Omid Halse, MRCP; Paul Bentley, PhD; Pankaj Sharma, MD, PhD, FRCP, Published on Stroke, 10 November 2015