But do they get tPA delivered within 3 minutes for full recovery? The goal is 100% recovery; NOT YOUR FUCKING TYRANNY OF LOW EXPECTATIONS of improve outcomes!
In this research in mice the needed time frame for tPA delivery is 3 minutes for full recovery.
Electrical 'storms' and 'flash floods' drown the brain after a stroke
Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? Your patients need an explanation of why you aren't working on survivor requirements of 100% recovery protocols.
The latest here:
Mobile Stroke Unit Reduces Door-to-Puncture Time in LVO-Related Ischemic Stroke
There are more favorable time metrics for patients transported by mobile stroke unit compared with those transported by EMS. Patients transported by a mobile stroke unit have more favorable time metrics, but have similar outcomes as those transported by emergency medical services (EMS). These findings were published inStroke: Vascular and Interventional Neurology Investigators from Grady Memorial Hospital in the United States hypothesized that patients transported by mobile stroke unit afte occlusion (LVO)-related ischemic stroke(IS) would have faster time metrics when receiving mechanical thrombectomy than patients transported by EMS. This study was a cross-sectional retrospective review of prospectively collected data between 2018 and 2023. Patients (N=565) who received endovascular therapy for LVO-related IS were evaluated for the endpoints of time interval between door-to-imaging, door-to-puncture, and door-to-reperfusion on the basis of whether they arrived at the hospital by mobile stroke unit (n=66) or EMS (n=499). The mobile stroke unit and EMS cohorts comprised 55% and 56% men, they had median ages of 66 (IQR, 47-77) and 66 (IQR, 56-76) years, they had an Alberta Stroke Program Early Computed Tomography (ASPECTS) score of 9 (IQR, 8-10) and 8 (IQR, 7-10), and the most common occlusion locations were middle cerebral artery M1 (39% vs 42%) or M2 (38% vs 23%), respectively. Safety and clinical outcomes were comparable among MSU and EMS-transport groups, supporting the need for further investigation of the direct-to-angio approach for patients with LVO.
Patients who arrived by mobile stroke unit had shorter door-to-imaging (median, 9 vs 17 min;P<.001), -puncture (median, 58 vs 82 min; P<.001), and -reperfusion (median, 96 vs 127 min; P<.001) than patients who arrived by EMS. In the linear regression analysis, door-to-puncture was significantly shorter with mobile stroke unit than with EMS (b, -23.3; 95% CI, -34.7 to -11.9;P<.001). The significant shortening of time from door-to-puncture with mobile stroke unit was significantly mediated by multimodal imaging (8%;P=.012), time to multimodal imaging completion (53% P<.001), and time to any imaging completion (48%;P<.001). Direct-to-angio was not a significant mediator (P=.132). The mobile stroke unit- and EMS-transported patients did not differ by modified Rankin Scale (mRS) score at discharge (median, 3 vs 3; P=.198), mRS score at 90 days (median, 3 vs 3;P=.455), or mortality at 90 days (23% vs 20%; P=.691).This study was not powered to detect significant differences in clinical outcomes. The study authors concluded, “MSU [mobile stroke unit transport was associated with improved workflow leading to shorter times to treatment. Safety and clinical outcomes were comparable among MSU and EMS-transport groups, supporting the need for further investigation of the direct-to-angio approach for patients with LVO.” This article originally appeared on The Cardiology Advisor
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