Tuesday, April 9, 2019

Applying New Guidelines, Imaging, and Insights on Extending the Treatment Window in Acute Ischemic Stroke

Maybe you want to have your hospital require this training. Although you will notice this is still just guidelines NOT PROTOCOLS. Survivors will need to be in charge of stroke before we ever get protocols and 100% recovery.  Whatever stroke leadership there is is obviously lazy and just waiting for SOMEONE ELSE TO SOLVE THE PROBLEMS IN STROKE!

 

Applying New Guidelines, Imaging, and Insights on Extending the Treatment Window in Acute Ischemic Stroke

The 2018 AHA/ASA Guidelines for the Early Management of Patients With Acute Ischemic Stroke include which of the following new recommendations?

  • When several intravenous (IV) alteplase-capable hospital options exist within a defined geographic region, the benefit of bypassing the closest to bring the patient to one that offers a higher level of stroke care is certain.
  • Tenecteplase 0.4-mg/kg single IV bolus is superior to alteplase and can be considered in patients with major neurological impairment and intracranial occlusion.
  • For patients with acute ischemic stroke (AIS), administration of IV alteplase, guided by telestroke consultation, may be as safe and beneficial as that of stroke centers.
  • For otherwise eligible patients with mild stroke presenting in the 4.5- to 6-hour window, treatment with IV alteplase may be reasonable.

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