Neurohospitalists Improve Door-to-Needle Times for Patients With Ischemic Stroke Receiving Intravenous tPA

Improving Door-to-Needle Times for Acute Ischemic Stroke

Faster treatment with intravenous alteplase (tissue-type plasminogen activator) results in better outcomes. Although the benchmark door-to-needle time (DTN) has been set at 60 minutes, many centers have been able to exceed this benchmark with median times from 20 to 51 minutes. These local efforts have been supported by national and international efforts to reduce DTN time. For example, the Ame...

Door-to-needle time and the proportion of patients receiving intravenous thrombolysis in acute ischemic stroke: uniform interpretation and reporting.

Simple text-messaging intervention is associated with improved door-to-needle times for acute ischemic stroke.

BACKGROUND AND PURPOSE Timely administration of intravenous tissue-type plasminogen activator (IV tPA) is associated with improved outcomes for acute ischemic stroke; yet, developing processes to consistently provide prompt treatment remains a challenge. We developed and evaluated a simple quality improvement intervention designed to improve door-to-needle (DTN) times for resident-led Code Stro...

Symptom-to-needle Times in Acute Ischemic Stroke and Its Prehospital Related Factors

Background: Intravenous (IV) recombinant tissue Plasminogen Activator (rtPA) (IV-rtPA) is the only FDA-approved pharmacological therapy for treatment in acute ischemic stroke and the administration of IV-rtPA is crucially time-dependent. Objectives: This study aimed to evaluate symptom-to-needle time and factors associated with the prehospital delay in patients with acute ischemic stroke refer...

Short Door-to-Needle Times in Acute Ischemic Stroke and Prospective Identification of Its Delaying Factors

BACKGROUND The clinical benefit of intravenous thrombolysis (IVT) in acute ischemic stroke is time dependent. Several studies report a short median door-to-needle time (DNT; 20 min), mainly in large tertiary referral hospitals equipped with a level 1 emergency department, a dedicated stroke team available 24/7, and on-site neuroimaging facilities. Meanwhile, in daily practice, the majority of s...