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NEUROLOGY 2006;67:334-336
© 2006 American Academy of Neurology
Brief Communications

Door to thrombolysis: ER reorganization and reduced delays to acute stroke treatment

P. J. Lindsberg, MD, PhD, O. Häppölä, MD, PhD, M. Kallela, MD, PhD, L. Valanne, MD, PhD, M. Kuisma, MD, PhD and M. Kaste, MD, PhD, FAHA

From the Departments of Neurology (P.J.L., O.H., M.K., M.K.) and Radiology (L.V.), Neuroscience Program (P.J.L.), Biomedicum Helsinki, Helsinki Emergency Medical Services (M.K.), Helsinki University Central Hospital, Helsinki, Finland.

Address correspondence and reprint requests to Dr. Perttu J. Lindsberg, Emergency Neurology Services, Department of Neurology, Biomedicum Helsinki, PO Box 700 (Haartmaninkatu 8), 00029 HUS, Helsinki, Finland; e-mail:perttu.lindsberg{at}hus.fi

The authors reorganized the emergency room (ER) by moving CT to the ER and streamlining triage by prenotification by emergency medical services (EMS), which reduced in-hospital delays and enhanced access to stroke thrombolysis. CT delay dropped from 1 hour 3 minutes ± 14 minutes in 1999 to 7 ± 2 minutes in 2004 (p < 0.0001). Door-to-needle time dropped from 1 hour 28 minutes ± 7 minutes to 50 ± 3 minutes (p < 0.001), while symptom-to-needle time dropped from 2 hours 44 minutes ± 6 minutes to 2 hours 5 minutes ± 4 minutes (p < 0.0001). From 23 patients in 1999, thrombolysis access was increased to 100 patients in 2004 and 183 patients in 2005.

P.J.L. is supported by the Finnish Academy, Sigrid Jusélius Foundation, HUCH EVO-grants, Päivikki and Sakari Sohlberg Foundation, and Maire Taponen Foundation.

Disclosure: The authors report no conflicts of interest.

Received August 18, 2005. Accepted in final form March 23, 2006.




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