A Stroke Code and cooperation between doctors and nurses could reduce door-to-needle time for acute ischemic stroke

Endovascular Therapy for Acute Ischemic Stroke: Reducing Door-to-puncture Time

“…For patients with an indication for thrombectomy, the guidelines recommend intravenous thrombolysis with tPA and, if the occluded vessel is the internal carotid artery or M1 of the middle cerebral artery, endovascular treatment using a stent retriever is strongly recommended for lesions within 6 hours after the onset (Class I, Level of Evidence A). 7) Prior to this study, we attempted to shorten the time from onset to intravenous thrombolysis with tPA (DTN) 8) specifically by 1) introducing the stroke hotline, 2) speeding neurologic evaluation and simplifying examinations on the arrival at the emergency room, 3) preparing a stroke MRI protocol, and 4) nurse-initiated intravenous thrombolysis with tPA. By introducing the stroke hotline, it became possible to consider the possibility of intravenous thrombolysis with tPA/endovascular treatment at the point when the stroke physician is contacted or examines the patient and to request support to the endovascular treatment team.…”