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Who should pull the trigger on tPA for acute ischemic stroke? by Rhonda Cadena

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Who should pull the trigger on tPA for acute ischemic stroke? By Rhonda Cadena

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Who should pull the trigger on tPA for acute ischemic stroke? by Rhonda Cadena

  1. 1. Rhonda Cadena, MD University of North Carolina, Departments of Neurology, Neurosurgery, and Emergency Medicine WHO SHOULD PULL THE TRIGGER ON TPA FOR ACUTE ISCHEMIC STROKE?
  2. 2. TIMES ARE CHANGIN’
  3. 3. TIMES ARE CHANGIN’ tPA endovascular
  4. 4. THE PROBLEM… Saver. JAMA. 2013;309(23):2480-2488 Saver. Stroke. 2013;44:270-277
  5. 5. Time=0 Goal: DTN 60 ≤ minutes
  6. 6. THE PROBLEM…
  7. 7. Time=0 Goal: DTN 60 ≤ minutes
  8. 8. Time=0 FAST questions
  9. 9. PUSHING TPA, THE BASICS ▶ What do you need before pushing?  Clinical suspicion of stroke  FSBS without hypoglycemia  BP within parameters (< 180/110)  Minimal risk of hemorrhage, based on exclusion criteria  Patient weight  CT head without blood
  10. 10. STROKE SUMMARY ▶ Early treatment = Improved functional outcome ▶ Diagnosis and treatment needs to start as soon as possible and should begin with ‘911’ ▶ Pre-hospital screening, diagnosis, work-up, decision-making, and possibly treatment will be the future so get your weapon shined and ready to use
  11. 11. QUESTIONS?

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