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Inclusion Criteria: need an answer Yes to all questions
 | > or = 18 years of age |
| Clinical diagnosis of stroke with NIH stroke scale score < 22 |
| Time of onset of stroke known and is < 3 hours (defined as completely free of any stroke symptom) |
To be eligible for TPA: need answer YES to all questions
| BP Systolic <= 185, diastolic <= 110 |
| Not a minor stroke or rapidly resolving stroke |
| No seizure at onset of stroke |
| Not taking Warfarin (Coumadin) |
| Pro time <= 15 seconds or INR <= 1.7 |
| Not receiving heparin during the past 48 hours with elevated PTT |
| Platelet count >= 100,000 |
| Blood Glucose => 50 and <= 400 mg/dl |
| No acute myocardial infarction |
| No prior intracranial hemorrhage, neoplasm, AVM or aneurysm |
| No major surgical procedures within 14 days |
| No stroke or serious head injury within 3 months |
| No gastrointestinal or urinary bleeding within last 21 days |
| No lactation or Pregnancy within 30 days |
Consent from patient or family
Patient or family is aware of
| Risk of bleeding into the brain is 1 in 16 |
| Potential benefit: 30% greater chance of improvement to no or minimal disability |
| Patient or family sign consent form |
For a copy of sample admission orders for acute stroke patient given TPA, click here Sample TPA orders.
Anticoagulant to prevent stroke
Stroke information center
