Stroke Group Expands Time for Clot-Busting Drugs - @ JEMS.com


Stroke Group Expands Time for Clot-Busting Drugs

 

 
 
 

Jamie Stengle | | Friday, May 29, 2009


DALLAS -- A change to stroke treatment guidelines is expanding the time that some patients can get clot-busting drugs. Current recommendations limit the use of the medicine to within three hours after the start of stroke symptoms. That treatment window is now being lengthened to 4 1/2 hours for some patients.

But the committee that made the change stressed that the earlier the treatment, the better for stroke victims.

"They should call the ambulance straight away and get moving," said Dr. Gregory del Zoppo, of the University of Washington School of Medicine in Seattle, who headed the committee for the American Heart Association Stroke Council.

The update, published online Thursday in the heart group's journal Stroke, comes after a European study last fall found stroke sufferers still benefited from getting the medicine an hour or so beyond the three-hour window.

The new guideline is expected to increase the number of people who get the treatment. Only about a third of stroke sufferers get help within three hours, and only about 5 percent get the drug now. Many people don't recognize the signs of a stroke: numbness or weakness in the face, arm or leg; trouble speaking, seeing or walking; a sudden, severe headache.

Stroke is the third leading cause of death in the U.S., with about 795,000 people suffering a new or recurrent stroke each year and more than 140,000 people dying. Strokes caused by blood clots are the most common; the clot blocks an artery supplying blood to the brain, which starves brain cells of oxygen. The drug TPA breaks up the clot and opens the artery.

Another member of the committee, Dr. Jeffrey Saver, of the University of California at Los Angeles, said some hospitals extended the time for using the clot dissolver after the European study, while many have been waiting for national guidelines.

He said the change could increase the number of people who get the drug by a third, to 7 or 8 percent of stroke victims.

Dr. Mark D. Johnson, a stroke specialist at the University of Texas Southwestern Medical Center in Dallas, said that the expanded time frame is good news but the emphasis is still on getting treatment sooner rather than later.

"If you were to arrive in 30 minutes, the chances of a better outcome are higher than if you arrive in four hours," said Johnson.

The new guideline notes that some patients should still be restricted to treatment within the three-hour period: people older than 80, those suffering from a severe stroke or with a history of stroke and diabetes or those taking anti-clotting drugs.

___

On the Net: American Stroke Association:http://www.strokeassociation.org




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Leadership and Professionalism, Medical Emergencies, Special Patients

 
What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Innovation & Advancement

This is the seventh year of the EMS 10 Innovators in EMS program, jointly sponsored by Physio-Control and JEMS.
More >

Multimedia Thumb

Press Conference, East Village Explosion and Collapse

Fire is contained to four buildings; 12 people have been injured.
Watch It >


Multimedia Thumb

D.C. Mayor Adds Ambulances to Peak Demand Period

10 additional ambulances will be on the streets from 11 a.m. to 11 p.m.
Watch It >


Multimedia Thumb

Utah Commission Privatizes Ambulance Service

Mayors in Iron County loose management fight.
Watch It >


Multimedia Thumb

Ambulance Delay Raises Concerns over Response Times

Officers give up after waiting 20 minutes for an ambulance.
Watch It >


Multimedia Thumb

Patient Carry during Snowstorm

Firefighters, medics and officers lend a hand in Halifax.
More >


Multimedia Thumb

Terror Attack in Tunisia

19 people killed outside of a museum.
More >