Abstract W P339: Time Is Brain: A Tale of Unintended Consequences

Background: There is a narrow therapeutic range for thrombolysis in stroke. “Time is Brain” emphasizes the concept that nervous tissue is rapidly lost as stroke progresses. Research suggests 1.9 million neurons are lost each minute of untreated stroke. Urgency to treat led to the practice of estimating weight on arrival. Unfortunately, expediency of weight estimation can result in over or under dosing. After a devastating adverse outcome related to misdose of tPA based on estimated weight, SBUH implemented a protocol that ensures actual weight measurement before administration of thrombolytics without delaying time to treatment. Process: Our state accredited stroke program is recognized with the AHA Gold Plus Award. Door to needle time for tPA was below 60 minutes. Estimated weight dosing was standard as supported in the NINDS t-PA stroke study as not having negative impact on outcome. At SBUH in 2013 a patient had estimated weight entered of 90 kg. A CT Scan was performed within 9 minutes and tPA dose of...