Tuesday, January 9, 2018

Heaven on Wheels...








Tissue Plasminogen Activator (tPA) is a clot-busting drug. It can radically reduce the physical problems after stroke. tPA has been used for years, but not enough. There are 2 things that get in the way of tPA being used more:

1.There is reluctance among some MDs to administer it; they think they may get sued for causing a worse stroke (Note tPA is only for "block" ischemic stroke, but would make a "bleed" hemorrhagic stroke worse).

2. Survivors often miss the "window" of time tPA is thought to be effective (~3-4 hours). Only about one third of all survivors call 911 after their stroke. That is, very few survivors access emergency care that would be required to administer tPA.

The first issue, above, is discussed here. Irony: MDs are more likely to get sued if they don't administer tPA!

The second issue, this may change. There is new technology and it’s on wheels! Have a look at this vid.


More videos here.

3 comments:

oc1dean said...

Mobile scanners on wheels are just a stopgap until better diagnosis stuff already out there is implemented. For me 90 minutes wasn't fast enough to get fully recovered, although it might have saved my life.

Peter G Levine said...

Dean! The suggestion was that this might shave off 25 minutes. That'd be a good thing. The truck does the scan, has telemedicine with a neurologist and can administer tPA en route.

oc1dean said...

True Peter, but until we know exactly how fast tPA needs to be administered we can't set proper goals. I will agree that tPA administration in less than 4.5 hours will reduce severity of the stroke, but that is not the goal we should be shooting for. Full recovery is the goal, it is like JFK saying we are going to the moon in 10 years, no clue how or if possible, but intelligent and innovative people accomplished that impossible goal. Soapbox time, friends have told me I need to get on a TED talk. It wouldn't go over well but would be entertaining for me.

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