It does say IV tPA should be considered in acute ischemic stroke patients who meet ECASS III inclusion/exclusion criteria and can be treated between 3 to 4.5 hours after symptom onset; however, the effectiveness of tPA is less well established in institutions without the systems in place to safely administer the medication (Level B recommendation).
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ACEP News: Vol 32 – No 04 – April 2013ACEP worked with AAN on this joint policy at the urging of members of both organizations. It reflects more than 8 years of work by a task force that was sensitive to the controversies but committed to an unbiased analysis of the literature.
Dr. Jagoda is professor and chair, the department of emergency medicine, Mount Sinai School of Medicine, and medical director of the emergency department at Mount Sinai Hospital, New York, N.Y. He was part of the development panel for the IV tPA clinical policy and is a member of the ACEP News Editorial Advisory Board.
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