Emergency department-focused thrombolysis for acute ischaemic stroke.
Acute ischaemic stroke (AIS) is a leading cause of death and disability. Until the 1990s early intervention in AIS was limited to prevention of secondary brain injury. Early thrombolysis has now become standard practice in many areas of the world. Despite the evidence of benefit, the lack of good alternative acute treatments and the recent shift in political focus to stroke management, a thrombolytic strategy for AIS has been very slow to develop in the UK. In this paper, the successful introduction of thrombolysis for AIS through the development of an emergency department-focused process is reported. Obstacles to service development and ways to overcome these are discussed and this therapeutic process is demonstrated to be both possible and self-sustaining in most UK hospitals.
Kaye
Phil
P
Department of Emergency, Royal United Hospital, Combe Park, Bath BA1 3NG, UK. philip.kaye@ruh-bath.nhs.uk
Shaw
Louise
L
Madigan
Barbara
B
Jakeman
Nicola
N
D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054869:Clinical Audit; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome