Multiple Administrations of Intravenous Thrombolytic Therapy to a Stroke Mimic
| Autor: | Lindsey Gurin, Ava L. Liberman, Steven Tversky, Michael G Fara, Cen Zhang, Sara K. Rostanski, Daniel Antoniello |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Article Brain Ischemia 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents medicine Humans Thrombolytic Therapy In patient cardiovascular diseases 030212 general & internal medicine Intensive care medicine Stroke Acute ischemic stroke Psychiatric Disease business.industry Stroke mimics Health information exchange Middle Aged medicine.disease Treatment Outcome Tissue Plasminogen Activator Hemorrhagic complication Emergency Medicine Administration Intravenous Health information Emergency Service Hospital business 030217 neurology & neurosurgery |
| Zdroj: | J Emerg Med |
| ISSN: | 0736-4679 |
| DOI: | 10.1016/j.jemermed.2019.10.004 |
| Popis: | Background Patients who present emergently with focal neurological deficits concerning for acute ischemic stroke can be extremely challenging to diagnose and treat. Unnecessary administration of thrombolytics to potential stroke patients whose symptoms are not caused by an acute ischemic stroke—stroke mimics—may result in patient harm, although the overall risk of hemorrhagic complications among stroke mimics is low. Case Report We present a case of a stroke mimic patient with underlying psychiatric disease who was treated with intravenous alteplase on four separate occasions in four different emergency departments in the same city. Although he did not suffer hemorrhagic complications, this case highlights the importance of rapid exchange of health information across institutions to improve diagnostic quality and safety. Why Should an Emergency Physician Be Aware of This? Increased awareness of stroke mimics by emergency physicians may improve diagnostic safety for a subset of high-risk patients. Establishing rapid cross-institutional communication pathways that are integrated into provider's workflows to convey essential patient health information has potential to improve stroke diagnostic decision-making and thus represents an important topic for health systems research in emergency medicine. |
| Databáze: | OpenAIRE |
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