Ischemic Stroke - Hennepin County Medical Center

News Notes
Team releases data on stroke
treatment times at 2008 International
Stroke Conference cont.
A 24/7 dedicated stroke responder team,
which included neurology residents, vascular
neurology fellows, and neurology staff.
A dedicated stroke pager for each team
member and a system that allowed all
pagers to be activated simultaneously when
a potential stroke patient was en route.
24/7 availability of neurology and
radiology staff members to assist the
emergency department.
Protocols developed for evaluation
and treatment of potential ischemic
stroke patients.
Before/after data show significant shifts that
occurred after the stroke team was in place:
In 2004, 9% of potential stroke patients
received IV tPA. In 2006, that number rose
to 17% of potential stroke patients, bringing
the hospital in line with a handful of top
national performers in tPA administration.
In 2004, the mean door-to-needle time (e.g.
the time from patient arrival to commencement
of IV tPA) was 73 minutes. In 2006,
that number dropped to 43 minutes.
However, the number of patients receiving IV
tPA decreased slightly and the mean door-toneedle
time increased slightly in 2007, suggesting
the importance of continued vigilance in
speed of treatment for stroke patients.
The presentation is available online for a
fee. To purchase it and/or other educational
presentations from the conference, visit
www.scienceondemand.org and search under
“2008 International Stroke Conference.”
_____________________________________
Clinical trials underway through the
NETT Network
Each year, more than one million Americans
experience some type of acute devastating
neurological illness or injury, ranging from
ischemic stroke, to head and spinal cord
injuries, to bacterial meningitis. Medical management
of these problems often is hampered
because treatments are understudied, based
on limited evidence, or ineffective. A new network
of hospitals is launching multi-centered
clinical trials that will benefit patients with
neurology illnesses and injuries.
In 2003, a group of emergency room physicians
and neurologists from across the U.S.
met to discuss the problem and formed the
Neurological Emergencies Treatment Trial
(NETT) Network. The NETT Network, which
recently has received funding from the National
Institute of Neurological Disorders and Stroke,
is a nationwide effort to improve the outcomes
of these patients through interventional clinical
research, focused on the emergent phase of
patient care.
The NETT Network aims to conduct simple
multi-centered clinical trials of potential new
therapies for a wide range of neurological problems.
Each research study conducted by the
NETT will be streamlined, with simple research
questions that can be answered through the
collection of a minimal amount of data at the
patients’ bedside. The NETT Network includes
academic centers as well as community and
rural sites in order to enroll patients who are
cared for in diverse settings. Several Minnesota
hospitals will be participating and will assist in
enrolling patients in future clinical research trials.
For more information, visit nett.umich.edu/nett.
20 | Approaches in Critical Care | December 2008