What is the ideal door-to-needle time for IV tPA administration in many EDs?

What is the ideal door-to-needle time for IV tPA administration in many EDs?

• A. 60 minutes
• B. 90 minutes
• C. Under 45 minutes
• D. 120 minutes

Answer: (C)

Prompt treatment with IV tPA in acute ischemic stroke is highly time-dependent—the quicker you start therapy after arrival, the more brain tissue you can save and the better the potential outcome. In many emergency departments, the ideal target is to begin IV tPA within 45 minutes of arrival. This aggressive goal drives streamlined processes: rapid triage and pre-notification, immediate CT to rule out hemorrhage, fast eligibility checks, and immediate drug administration once there are no contraindications. While 60 minutes is a common achievable benchmark, aiming for under 45 minutes represents the best-performing standard in many settings. Longer times, like 90 or 120 minutes, are associated with worse outcomes due to prolonged ischemia.

Prompt treatment with IV tPA in acute ischemic stroke is highly time-dependent—the quicker you start therapy after arrival, the more brain tissue you can save and the better the potential outcome. In many emergency departments, the ideal target is to begin IV tPA within 45 minutes of arrival. This aggressive goal drives streamlined processes: rapid triage and pre-notification, immediate CT to rule out hemorrhage, fast eligibility checks, and immediate drug administration once there are no contraindications. While 60 minutes is a common achievable benchmark, aiming for under 45 minutes represents the best-performing standard in many settings. Longer times, like 90 or 120 minutes, are associated with worse outcomes due to prolonged ischemia.