Volume 182 - Issue 1
Tissue plasminogen activator (tPA) in acute ischaemic stroke: time for collegiate communication and consensus
Authors: Ian R Rogers, George A Jelinek and Ian Jacobs
Med J Aust 2005; 182 (1): 44-45. || doi: 10.5694/j.1326-5377.2005.tb06560.x
Published online: 3 January 2005
Published online: 3 January 2005
Ian R Rogers,* George A Jelinek,† Ian Jacobs*
* Associate Professor, † Professor, Discipline of Emergency Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA 6009. Ian.RogersAThealth.wa.gov.au
To the Editor: We applaud the call of Levi and his co-contributors for collegiate communication and consensus regarding the use of tissue plasminogen activator in acute ischaemic stroke.1 Emergency care providers are acutely aware of their role at the centre of the acute healthcare system. Daily, we interact with colleagues from other disciplines in the course of seeking the best clinical care for our patients.
However, the views expressed by Hoffman2 are shared by many emergency physicians and prehospital care providers. We remain unconvinced of the role of thrombolysis in acute ischaemic stroke outside the setting of properly constituted clinical trials.
On review of the contributors list in Levi’s article, we are unable to identify a single specialist emergency medicine or prehospital care provider. Consensus is not likely to be achieved until position statements from expert groups include a strong representation from all the specialty disciplines involved in the care of stroke patients. We look forward to developments in this direction.
References
- Levi CR, on behalf of the Australasian Stroke Unit Network, the New South Wales Greater Metropolitan Transition Taskforce Stroke Initiative, and the Towards A Safer Culture Stroke Expert Working Group. Tissue plasminogen activator (tPA) in acute ischaemic stroke: time for collegiate communication and consensus. Med J Aust 2004; 180: 634-636.
- Hoffman JR. Tissue plasminogen activator (tPA) for acute ischaemic stroke: why so much has been made of so little [editorial]. Med J Aust 2003; 179: 333-334. i1085657