Sea Change Expected in Hospital Treatment of Stroke

By Carrell, Steve | Drug Topics, February 19, 1996 | Go to article overview

Sea Change Expected in Hospital Treatment of Stroke


Carrell, Steve, Drug Topics


Stay tuned for new hospital stroke teams (including pharmacists), big alterations in stroke treatment, major changes in emergency care, plus more news to come.

Much of the hoopla at the recent American Heart Association's annual stroke conference stemmed from a federal study showing t-PA as the first treatment for acute stroke (see article in Drug Topics, Jan. 22, based on an article in the New England Journal of Medicine). But many experts, including conference chairman David Sherman, M.D., and Harold Adams Jr., M.D., head of AHA's stroke council, were reserving wholehearted endorsement of t-PA until the stroke conference was held in San Antonio in late January. Then supportive studies and plaudits from neurologist stroke experts worldwide bolstered the big-time drum-banging.

"People have been wanting to know the neurologic stroke community's consensus on t-PA. Putting all the trials together at this meeting, that [supportive] consensus has come out. The NIH study [alone] was so consistently positive that I'd unequivocally say t-PA is a proven effective therapy for [selected patients with] acute stroke," said Sherman, a professor and chief of neurology at the University of Texas Health Science Center at San Antonio.

But to make t-PA work, a hospital needs a coordinated treatment team; the best results occur when a patient receives t-PA within three hours after stroke. Hospitals in the study had someone in the emergency department, usually a nurse or physician, to activate other team members' beepers when a potentially qualified patient. appeared. If t-PA was not stored in the emergency department, a pharmacist began preparing the drug, sometimes even before the need was confirmed. Meanwhile, stat blood work and a CT scan helped provide diagnostic criteria. A physician, usually a neurologist or trained emergency physician, read the information and decided whether to give t-PA. Then the patient received extremely close monitoring in the intensive care unit, because t-PA has potentially dangerous hemorrhagic side effects.

At a news conference in San Antonio, several researchers said their teams' best performance was 20-30 minutes, but the process usually took an hour. Acknowledging that all hospitals cannot muster such a team, especially at night, researchers suggested designating certain hospitals as regional stroke centers.

But hospitals must consider the cost of the new treatment. For instance, one study site, Henry Ford Hospital in Detroit, is analyzing the higher immediate costs versus the economic benefits of preventing long-term disability or death, said study researcher Steven Levine, M.D., the hospital's stroke unit director. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Sea Change Expected in Hospital Treatment of Stroke
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.