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- Jan 21, 2004
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Hey, quick question for the neuro folks out there...
I was working at my job last week when a guy came in with a stroke into the ER
We initiated protocol and sent him for CT, got bloods appropriate for tPA like PT/PTT and INR
At first, the neuro resident wasn't going to give tPA since he was on coumadin, but his INR came back kind of low (1.4), so it was decided to give him tPA
So anyways, we were going to give him tPA since the time was about 2 hrs 40 minutes, but then the family member said she wasn't sure if the symptoms start at the original time she told us, and she said they might have started 30 min earlier which would have been 3 hrs 10 minutes
This is out of the tPA window of 3 hrs, so we didn't give it to him
My question is, what happens, physiologically speaking, with the stroke that makes it so you can't give tPA after 3 hrs after the start of symptoms when it's fine before 3 hrs?
I'm not particularly interested in neuro as a career (as my name would suggest), but I find every field of medicine interesting, and have been curious about this question since last week...
I was working at my job last week when a guy came in with a stroke into the ER
We initiated protocol and sent him for CT, got bloods appropriate for tPA like PT/PTT and INR
At first, the neuro resident wasn't going to give tPA since he was on coumadin, but his INR came back kind of low (1.4), so it was decided to give him tPA
So anyways, we were going to give him tPA since the time was about 2 hrs 40 minutes, but then the family member said she wasn't sure if the symptoms start at the original time she told us, and she said they might have started 30 min earlier which would have been 3 hrs 10 minutes
This is out of the tPA window of 3 hrs, so we didn't give it to him
My question is, what happens, physiologically speaking, with the stroke that makes it so you can't give tPA after 3 hrs after the start of symptoms when it's fine before 3 hrs?
I'm not particularly interested in neuro as a career (as my name would suggest), but I find every field of medicine interesting, and have been curious about this question since last week...