- Joined
- Aug 12, 2011
- Messages
- 287
- Reaction score
- 8
In SC, had a guy came in right away with R sided dense hemiplegia. Stat CT shows a textbook L MCA infarct. The neuro on-call was a complete ***hole usually. This was a Sunday evening, around 9pm. However, neuro came in, and gave this pt the t-PA. It was truly incredible. The guy came to life right in front of my eyes.
There are the total scoffers here on SDN that say, bar none, when someone gets better after t-PA, it is because they were having a TIA. For this one anecdotal case, with a positive (not equivocal or negative) CT, it worked. That's enough to convince me that it isn't worthless, as some here might make you think. I mean, if it truly was, considering the risk of bleeding, then why do P&T committees nationwide still have it on formulary, while pulling droperidol? It is NOT all bad and no good, as some people here might make you think.
Okay, so bottom, bottom line: get through rotations and EM residency, gain a bunch of experience, see first hand what tPA does in different scenarios, and develop your own opinion of it.