Revising the use of thrombolytics in ischemic stroke could reverse nationally accepted practices, guidelines in the ED

This [Up for Reconsideration: Clinical Policy on IV tPA for Ischemic Stroke] is actually, really, a very important issue. Revisiting the issue of the use of thrombolytics in ischemic stroke has the potential of setting the EM industry on its head as regards stroke networks. The Joint Commission now requires that hospitals that are “stroke centers” treat 50% of eligible candidates with ischemic stroke within one hour of arrival!! This is policy set in place across the nation.

How odd, then, will it be if, when we revisit this, we end up reversing a policy that is accepted nationally and drives a vast amount of commerce in this country and around the world? This is going to be a very hot topic, one that we will all be attuned to with bended ear.

Thus, this is a very important subject, and exceedingly timely. I respectfully suggest that you do an updated mail-out to the membership of ACEP which provides the link. There are thousands of us across the nation with the “need to know.”

Again, thank you for your time.

—Raymond L. Fowler, MD, FACEP, DABEMS
Dallas, Texas