title: Views on the use of tissue plasminogen activator in acute ischemic stroke: a state-wide survey among neurologists and emergency medicine physicians in Indiana.
abstract: Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25% responded in concordance with published American Heart Association guidelines in all cases. Only 19% gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85% v 49%; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.
authors: Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
authors: J F
authors: JF
authors: Meschia
authors: L S
authors: LS
authors: Williams
authors: J D
authors: JD
authors: Fleck
authors: A
authors: A
authors: Bruno
authors: J
authors: J
authors: Biller