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DGDispatch 
Effectiveness Of tPA Use In Community Hospitals Enhanced By Rapid Response Team: Presented at NASMBy Lynn Haley Special to DG News
SAN DIEGO, CA -- August 19, 2001 -- Community hospitals should consider developing a Rapid Response Team to better facilitate the needs of stroke patients, researchers recommend. The recommendation, by researchers at LeHigh Valley Hospital, in Allentown Pennsylvania, was made at the 2001 North American Stroke Meeting held here August 15th -18th. Investigators developed a Rapid Response Team (RRT) modelled on a Trauma Centre at their institution based on recommendations by the National Stroke Association (NSA). Educational programmes on the need for a quick response were provided to emergency room staff as well as to members of the community. Data were collected, recorded and analysed. From 1996 to 1999, 20 patients received tPA. The average time from door to clinical evaluation for stroke patients was approximately 20 minutes. The mean time from door to the time patient received a computed tomography (CT) scan was 25 minutes; door to drug administration was 47-140 minutes. After 10 years of using thrombolytic agents for the treatment of stroke, investigators say changes were necessary in the way these patients are managed, to reduce treatment time. Better co-ordination of care and a systematic approach to assessment, diagnosis and intervention can improve the outcome for these patients. Their results showed that with the implementation of the RRT, they achieved the necessary improvement to better the chances for stroke patients. Door to evaluation was reduced to seven minutes; door to CT scan, 20 minutes; and door to drug, 92 minutes. The researchers concluded that such outcomes validate the effectiveness of implementing a co-ordinated approach to the treatment of stroke patients in a community hospital. They recommend that resources be allocated to enhance quick intervention to facilitate brain recovery. Further education of the public on the benefits of early access is also desirable, they said. Continued improvement in the management of the acute event is also suggested.
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