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    Delays in the stroke thrombolysis pathway - Identifying areas for improvement

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    Authors
    Brewer, L
    Arize, C
    Williams, D
    Issue Date
    2014-05
    Keywords
    STROKE AND TIA
    
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    Citation
    Brewer L, Arize C, Williams D. Delays in the stroke thrombolysis pathway - identifying areas for improvement. Ir Med J 2014 May 107 (5)
    Publisher
    Irish Medical Journal
    Journal
    Irish Medical Journal
    URI
    http://hdl.handle.net/10147/316726
    Abstract
    Despite international consensus on the benefits of thrombolysis for ischaemic stroke (IS), it remains underused. Guidelines now recommend a door-to-needle time of d60 minutes. We reviewed the rate and timeliness of thrombolysis for IS at our hospital. 323 stroke patients presented between January 2011 and April 2012.Thirty patients (10.6% of IS) were thrombolysed, mean age was 68.5 years (42 to 88) and 19 patients (63%) were male. Thirty-six patients (12.7% of IS) were not thrombolysed despite arriving within the time-window and symptom resolution was the commonest reason (15 patients; 42%). Despite most thrombolysed patients (42%) presenting to the Emergency Department during daytime working hours, there were delays at each step of the acute care pathway. The mean time for stroke team review was 23 minutes (5-50). The mean door-to-CT and the door-to-needle times were 60 minutes (25-95) and 92 minutes (46-130) respectively. In parallel with national stroke incentives, local audit can highlight barriers to uptake and efficiency within thrombolysis services.
    Item Type
    Article
    Language
    en
    Collections
    Beaumont Hospital

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