ArticleScandinavian journal of trauma, resuscitation and emergency medicine2016
Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Reducing care time after implementing protocols for acute ischemic stroke: a systematic review.Arquivos de neuro-psiquiatria · 2022Pooled it
- Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis.Implementation science : IS · 2020Pooled it
- Pooled it
- Analysis of door-to-needle time for thrombolysis in acute ischaemic stroke using statistical process control charts.BMJ neurology open · 2024Article
- Who is in the emergency room matters when we talk about door-to-needle time: a single-center experience.Arquivos de neuro-psiquiatria · 2023Article
- Article
- Immediate effects of urgent reorganisation of emergency department-based treatment pathway in nonperforated appendicitis: a retrospective study.BMC emergency medicine · 2020Article
- Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?BMC medical education · 2019Article
- Factors Affecting the Effective Management of Acute Stroke: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2018Article
- Emergency medicine for 25 Years in Iceland - history of the specialty in a nutshell.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Knowledge and Attitudes of Saudi Emergency Physicians toward t-PA Use in Stroke.Neurology research international · 2018Article
- Comparing the National Institutes of Health Stroke Scale Scores between emergency medicine physicians and neurologists for timely decision-making for alteplase administration.Turkish journal of emergency medicineArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTissue plasminogen activator (tPA) treatment for acute ischaemic stroke (AIS) should be given as soon as possible, preferably within 60 min after arrival at hospital. There is great variation in door-to-needle times (DNTs) internationally, nationally and even within the same hospital. Various strategies for improving treatment delays have been presented. The role of emergency physicians (EPs) in treating AIS has been under discussion in recent years. Emergency Medicine (EM) officially became a specialty in Finland in 2013. Practical education of EPs in Kanta-Häme Central Hospital began in October 2012, together with reorganization of the in-hospital treatment path for AIS patients. The main change was shifting the on-call duty regarding stroke patients from internists or neurologists to EPs after the third quarter of 2013.
methodsThis was a retrospective study. The data, concerning the characteristics of tPA-treated patients, DNTs and onset-to-treatment times (OTTs) was collected from electronic and paper records. The period studied was 1 year before and 1 year during reorganization, i.e. 2012 and 2013.
resultsDuring the study period a total of 64 tPA treatments were given, 31 before and 33 during reorganization. The median DNT was 54 min in 2012, while it was 28 min in 2013 (p < 0.001). The median OTTs were 139 and 101 min before and during the start of reorganization, respectively (p < 0.001).
conclusionsBoth total and in-hospital delays in the treatment of ischaemic stroke were shortened significantly during reorganization. Emergency physicians are able to treat AIS patients within international time guidelines. Success was based on scrutinized reorganization and good cooperation between neurologists, EPs and radiologists.
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