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. 2009 Mar 30:1:29-37.
doi: 10.4137/jcnsd.s2231. Print 2009.

Views of emergency physicians on thrombolysis for acute ischemic stroke

Bentley J Bobrow  1 , Bart M Demaerschalk, Joseph P Wood, Albert Villarin, Lani Clark, Anthony Jennings
Affiliations

Views of emergency physicians on thrombolysis for acute ischemic stroke

Bentley J Bobrow et al. J Brain Dis. .

Abstract

Background: The 3-hour window for treating stroke with intravenous tissue plasminogen activator (t-PA) requires well-organized, integrated efforts by emergency physicians and stroke neurologists.

Objective: To evaluate attitudes and knowledge of emergency physicians about intravenous t-PA for acute ischemic stroke, particularly in primary stroke centers (PSCs) with stroke neurology teams.

Methods: A 15-question pilot Internet survey administered by the Arizona College of Emergency Physicians.

Results: Between March and August 2005, 100 emergency physicians responded: 71 in Arizona and 29 in Missouri. Forty-eight percent practiced at PSCs; 48% thought t-PA was effective, 20% did not, and 32% were uncertain. PSC or non-PSC location of practice did not influence endorsement (odds ratio, 0.96; 95% confidence interval, 0.27-1.64). Of those opposing t-PA, 87% cited risk of hemorrhage.

Conclusions: Most emergency physicians did not endorse t-PA. Improved collaboration between emergency physicians and stroke neurologists is needed.

Keywords: acute ischemic stroke; emergency physician; primary stroke center; stroke neurologist; thrombolysis.

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References

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