Checklists Help Select Thrombolysis Candidates in the Emergency Department

Identifying stroke mimics remains a source of disagreement between emergency medicine and vascular neurology specialists.

Checklists aid decision-making across disciplines and are becoming more accepted in medicine. Accurately identifying patients with stroke-like symptoms who qualify for thrombolysis is important, as both over- and undertreatment can expose patients to additional risk.

Researchers at a high-volume stroke center studied the impact of a comprehensive eligibility checklist on agreement about tPA treatment decisions between emergency medicine residents and vascular neurology fellows in the emergency department (ED). Each of 60 patients was simultaneously evaluated by an EM resident and a vascular neurology fellow, who completed the checklists independently and did not discuss treatment decisions.

Use of the checklist led to substantial agreement (k…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)