presented at Genentech submeeting by Dr Grotta. A few of his ideas
1. We need to relax many of the criteria for i-v tpa so that 10-20 percent of patients get drug. What IS needed to give drug is: NIHHSS, time of onset, plain CT head, (no CTA till after infusion started), history of bleeding, seziures, surgery, stroke, meds, glucose, platelets and HCT. NO Foley, CXR (unless suspicion of dissection), ECHO or INR unless on warfarin or heparin
2. At his center, he has experience treating patients with wake-up strokes with success middling between placebo and standard 0-3 hour patients.
3. Grotta believes that just as trauma is tiered into level one and two, so should stroke, and patients with level one stroke should be sent to comprehensive, not primary stroke centers where they can get better care. The scale utilized could be one that differentiates likelihood of major vessel occlusion, the Los Angeles...... scale.
4. His research includes tpa followed y arbogatran
1. We need to relax many of the criteria for i-v tpa so that 10-20 percent of patients get drug. What IS needed to give drug is: NIHHSS, time of onset, plain CT head, (no CTA till after infusion started), history of bleeding, seziures, surgery, stroke, meds, glucose, platelets and HCT. NO Foley, CXR (unless suspicion of dissection), ECHO or INR unless on warfarin or heparin
2. At his center, he has experience treating patients with wake-up strokes with success middling between placebo and standard 0-3 hour patients.
3. Grotta believes that just as trauma is tiered into level one and two, so should stroke, and patients with level one stroke should be sent to comprehensive, not primary stroke centers where they can get better care. The scale utilized could be one that differentiates likelihood of major vessel occlusion, the Los Angeles...... scale.
4. His research includes tpa followed y arbogatran
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