I hate strokes!!!

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suckstobeme

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I'm just venting here b/c "The Man" is making me do the NIH stroke scale online training right now.

I hate the Stoke Scale, I hate the NINDS trial, and I hate t-PA for strokes!

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What's the beef? You should be doing and documenting the stroke scale as soon as the patients get in the door. It takes like 10 seconds.

I do have an issue with tpa. Everyone else except ER says "push it, push it, why aren't you pushing it!" I recently had a case where the Neuro fellow insisted on pushing it. I called him again 10 minutes later from the CT scanner for him to review the bleed he just created and watched his "oh f*** "face drop as he called neurosurg.

Joe Lex has a very good lecture on tpa in strokes. Unfortunately, with every single stroke patient it becomes an argument with neurology.
 
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I do have an issue with tpa. Everyone else except ER says "push it, push it, why aren't you pushing it!" I recently had a case where the Neuro fellow insisted on pushing it. I called him again 10 minutes later from the CT scanner for him to review the bleed he just created and watched his "oh f*** "face drop as he called neurosurg.
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Such is life when you play with the Elixir of Death. Big time teachable moment right there. :(
 
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