• A Tveiten, A Mygland, U Ljøstad, and L Thomassen.
• Department of Neurology, Sørlandet Sykehus Kristiansand, 4604 Kristiansand, Norway. arnstein.tveiten@sshf.no
• Emerg Med J. 2009 May 1;26(5):324-6.

AimTo evaluate hospital delays in thrombolytic treatment before and after organisational changes and community-based treatment rates in a previously inexperienced centre.MethodsThe delays before and after organisational changes made in 2006 were compared using a prospective treatment database. In a 6-month period in 2007, a community-based search was performed for all hospitalisations for ischaemic stroke. The number of patients admitted within the 0-3 h time window and the proportion treated with tissue plasminogen activator were analysed.ResultsThe number of treatments increased fourfold from 2005 to 2007 with a significant reduction in mean door-to-needle time from 60 min to 38 min (p = 0.002). In the community-based series, 14/137 patients (10%) hospitalised with ischaemic stroke and 13/32 patients (41%) admitted in the 0-3 h window were treated.ConclusionsAn inexperienced stroke centre can rapidly implement the necessary logistics to deliver thrombolysis to a large proportion of patients with acute stroke with short hospital delays. Important factors are probably prenotification of a team and the initiation of thrombolytic treatment in the emergency room.

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