Stroke Care in the Emergency Room
Door to IV rt-PA Time
Ischemic stroke is a type of stroke where a blockage in a blood vessel in the brain causes damage to brain tissue. Research has shown that some patients who have this type of stroke benefit from the administration of Tissue plasminogen activator (IV-rtPA) to dissolve the blood clot that is causing the blockage in blood flow to the brain.
What are we measuring?
The percentage (%) of patients diagnosed with ischemic stroke and treated with IV-rtPA within 60 minutes (1 hour) of arriving in our Emergency Department, who arrived at our Emergency Department within 2 hours of their stroke symptoms beginning.
Why is this important?
Studies have shown that patient's who recieve IV rtPA within 3 hours of the onset of their stroke symptoms have the most benefit, however there are circumstances in which a patient will benefit from treatment with IV rtPA for up to 5 hours after stroke symptoms begin. BIDMC's goal is to treat all qualifying patients with IV-rtPA within 60 minutes of arrival in our Emergency Department, if their first stroke symptoms began 2 hours before their arrival.
What is our most recent performance and trend?
What are we doing to improve?
BIDMC reports its performance on this measure every quarter to the Massachusetts Department of Public Health Primary Stroke Service Registry. BIDMC routinely monitors the care of every patient that comes to the Emergency Department with stroke symptoms. Improvements in emergency stroke care include:
- Automated alerts to immediately page Stroke Team members to the ED bedside, to initiate neurological care, expedite CT scanning and streamline critical blood work.
- Established a Code Stroke Review Committee which reviews all stroke diagnoses and potential cases, to identify opportunities for continued improvement in patient care processes throughout the Medical Center.
Last Updated: January 2014