Waiting for thrombo(lysis)

One of the many terrifying aspects of our healthcare system that we
seem to be quietly accepting of is ambulance response times. In
England in December 2023 the median response time for a category 2
emergency call—which includes stroke calls—was 45 minutes, compared
with a target of 18 minutes. Of the callouts, 10% had a wait time of 1
hour 40 minutes or longer. For those unlucky people who are waiting
this long and have had a stroke amenable to intravenous thrombolysis
(IVT) [clot buster drug like tpa]  followed by thrombectomy [brain
surgery - clot removal], the time for any added benefit from IVT and
thrombectomy versus thrombectomy alone is nearly up before the
ambulance arrives, according to a new meta-analysis. The study looked
at individual patient data from six randomised control trials,
assessing levels of disability at 90 days. Benefits of IVT plus
thrombectomy versus thrombectomy alone were greater the sooner after
symptom onset that treatment was received, and by 2 hours 20 minutes
no statistically significant difference between the two interventions
was found.

JAMA doi:10.1001/jama.2024.0589 -
https://jamanetwork.com/journals/jama/article-abstract/2815005

from https://www.bmj.com/content/384/bmj.q601


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shes got a kid ... together -
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