This is because several studies have shown that fibrinolytic agents given to people of ECG interpretation) and must only do so in patients who meet certain criteria. A bleeding diathesis or active bleeding, (menstruation is an exception) . THROMBOLYTIC THERAPY. Saskatchewan Acute The patient meets inclusion criteria: acute ischemic stroke symptom and symptom onset. Growing body of literature supporting benefit of thrombolytics in AIS when meet NINDS inclusion/ . additional exclusion criteria: patients >80 years old, patients taking oral anticoagulants regardless of INR, patients with a baseline NIHSS.
The questionnaire contained 12 multiple-choice questions. One point was assigned for a correct answer and zero point for a false or unanswered question. Results One hundred and thirty-one neurologists The mean accuracy rate of 12 questions was The mean total score for respondents was 6. Conclusions The neurologists in this study were knowledge deficient in the area of intravenous fibrinolytic therapy for acute ischemic stroke.
This partially accounts for the low rate of fibrinolytic therapy in China.
Contraindications to Fibrinolytic Therapy
Electronic supplementary material The online version of this article doi: The survivors of stroke have the highest ratio of severe overall disability among sufferers of chronic diseases [ 3 ]. It is a huge burden on Chinese medical insurance and the economy [ 4 ]. Ischemic stroke is the most common type of stroke in China [ 4 ]. It accounts for Intravenous fibrinolytic therapy for acute ischemic stroke can improve neurological outcomes along with reducing the potential degree of disability [ 56 ].
It offers an effective treatment for stroke and the previous medical efforts chiefly focused on prevention of recurrence [ 7 ]. However, from September to Augustonly Low education and old ages of patients chiefly accounted for the low rate of fibrinolytic therapy. However, this study did not include the factors related to the treating physicians in the multivariate logistic regression analysis.
Some other studies regarding fibrinolytic therapy in developing countries mainly focused on the negative effects of financial constraint and insufficient infrastructure [ 910 ].
Nevertheless, these factors do not work in China. Fibrinolytic therapy has been covered by healthcare insurance in China since Most major general hospitals could supply infrastructure for the therapy [ 8 ]. For example, many Chinese physicians overemphasize the adverse effects associated with fibrinolytic therapy such as symptomatic intracerebral hemorrhage. With this in mind, the attitude of physicians can have a negative impact on patients or their families, who after consultation will likely refuse fibrinolytic therapy [ 8 ].
In this study, Chinese neurologists were surveyed regarding their knowledge of intravenous fibrinolytic therapy for acute ischemic stroke. Methods This study was performed in Shanxi Province, P. Shanxi Province is a poorly developed area of China. Shanxi Province consists of 11 regions. Twenty-seven major general hospitals are located in 10 of these regions. There were two criteria for eligible neurologists: Between May and Julyquestionnaires and invitations were mailed simultaneously to eligible neurologists who were invited to attend Shanxi Academy of Neurology Biennial Meeting.
For example, if the patient has a history of a previous stroke within the past three months, it may increase their risk of a bleed and exclude them from treatment with fibrinolytics. If a patient has a clinical presentation suggestive of a subarachnoid bleed, such as severe headache, orbital pain, vision loss and dizziness, even with a normal CT scan, treatment with a fibrinolytic agent may not be advised.
A previous subarachnoid bleed is also considered a contraindication.
Contraindications to Fibrinolytic Therapy | senshido.info
Additional contraindications include an arterial puncture at a non-compressible site within the previous week. Patients with evidence of active bleeding would also usually be excluded from fibrinolytic therapy. Another risk of fibrinolytic therapy is systemic bleeding, so certain conditions that increase the risk of systemic bleeding are also relative contraindications.
This includes an acute bleeding diathesis, such as a platelet count of less thanPatients who have uncontrolled hypertension with a systolic blood pressure of greater than mm Hg or a diastolic of greater than mm Hg may also be excluded. Blood glucose levels are also taken into consideration. Relative Contraindications A relative contraindication means that the patient may have a certain condition that puts him or her at a higher risk of developing a complication, but the benefits of therapy may outweigh the risks.
According to the American Heart Association, patients who have one or more relative contraindications may still be considered candidates for fibrinolytic therapy. If relative contraindications for fibrinolytic therapy are present in a stroke patient, consideration should be given to the extent or severity of the stroke symptoms and the overall health of the patient. One relative contraindication is rapidly improving stroke symptoms. The possible complications from therapy may not be worth the risk if symptoms are mild.
If the patient had a witnessed seizure when symptoms started and neurological impairments are evident following the seizure, the patient may not be considered to be a good candidate for fibrinolytic therapy.
A myocardial infarction within the previous three months may also exclude a patient from fibrinolytic therapy.