With well-trained personnel, it is possible to have a neurologist or other adequately trained specialist evaluate the patient, obtain suitable blood studies and a CT scan of the head without contrast, prepare and administer the rTPA within 45 minutes of a patient's entry into the ER.
The most critical component of this process is the specialist, who must obtain the history, perform a neurologic examination, review the CT scan and laboratory studies, discuss the data with patient and family members, elicit informed consent, and make the decision to treat or not to treat.
Copyright 2000