What is the time frame for fibrinolytic therapy?
During STEMI, fibrinolytic therapy must be instituted within 24 hours of symptom onset. After this time frame, fibrinolytic therapy is contraindicated and likely will not be effective.
Do you need an ECG before fibrinolytic therapy?
Who may need prehospital fibrinolysis? An ST-segment elevation myocardial infarction can be diagnosed using a 12-lead ECG obtained prior to reaching the hospital (in a patient with myocardial infarction symptoms such as crushing chest pain, for example).
What test should the patient receive within 25 minutes of hospital arrival?
Within 25 minutes of arrival at the emergency department, the stroke team or designee should review the patient’s history, establish a timeline of symptom onset, and perform a neurologic examination using either the NIH Stroke Scale or the Canadian Neurological Scale. Does CT scan show hemorrhage?
What are the guidelines for fibrinolytic therapy?
Systolic blood pressure under 185 mm Hg, diastolic blood pressure under 110 mm Hg. No evidence of acute trauma or bleeding. Not taking an oral anticoagulant, or if so, international normalized ratio (INR) under 1.7. If taking heparin within 48 hours, a normal activated prothrombin time (aPT)
What needs to be completed for this patient within 20 minutes after hospital arrival?
Do not delay CT, obtain CT without contrast within 20 minutes of patient arrival. A neurologic assessment by the stroke team or designee should be done within 20 minutes of patient arrival to the ED.
How do you know if you are a candidate for fibrinolytic therapy?
In order to be considered a suitable candidate for the therapy, patients must be over the age of 18 and have a firm diagnosis of ischemic stroke with deficits. Although fibrinolytic therapy may be the recommended treatment, in some cases the risks outweigh the benefits and the therapy is contraindicated.
What is the criteria for fibrinolytic therapy?
Fibrinolytic therapy works by dissolving clots which are obstructing blood flow to the brain. In order to be considered a suitable candidate for the therapy, patients must be over the age of 18 and have a firm diagnosis of ischemic stroke with deficits.