Stroke Thrombolysis Guidelines – Closing the Clinical Knowledge Gap

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Physician Assistant, Urgent Care

Stroke Thrombolysis Guidelines - 2021 Warning Regarding Stroke Thrombolysis Errors

Stroke Thrombolysis Guidelines - 2021 Warning Regarding Stroke Thrombolysis Errors - Closing the Clinical Knowledge Gap

What You Might Not Know About Stroke Thrombolysis Treatment Guidelines

A 2021 warning regarding stroke thrombolysis errors has been recently issued. The American Journal of Emergency Medicine (AJEM) published a review in March 2021 addressing the high error rate during emergent alteplase infusion for reversal of ischemic stroke.  According to this American Journal of Emergency Medicine (AJEM) review, what errors are most commonly associated with alteplase infusion and what are their clinical effects?

Try this stroke thrombolysis case and learn the errors are most commonly associated with alteplase infusion and their clinical effect.

A 57-year-old male presents to the emergency department (ED) with left-sided weakness that began 2.5 hours ago while he was watching TV.

His work-up shows that he is having an ischemic stroke and he is determined to be eligible for alteplase infusion.

Upon review 24 hours after his infusion, an error related to his alteplase is discovered.

Question:

Which of the following statements is correct with regards to the most common alteplase errors and their consequences when the drug is administered emergently to patients with ischemic stroke?

Answer Options:

Errors in alteplase administration are associated with a higher rate of hemorrhagic conversion.

Errors in alteplase administration are associated with a poorer functional outcome. 

Oversight of a contraindication is the most common error.

Overestimating an obese patient’s weight for dose calculation is the most common error.

See the Answer:


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