This clinical policy from the American College of Emergency Physicians is the revision of a clinical policy approved in 2012 addressing critical questions in the evaluation and management of patients with acute ischemic stroke.1 A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) Is intravenous tissue plasminogen activator safe and effective for patients with acute ischemic stroke if given within 3 hours of symptom onset? (2) Is intravenous tissue plasminogen activator safe and effective for patients with acute ischemic stroke treated between 3 to 4.5 hours after symptom onset? Evidence was graded and recommendations were made according to the strength of the available data.
Brown, M. D., Burton, J. H., Nazarian, D. J., & Promes, S. B. (2015, September 1). Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department from the. Annals of Emergency Medicine. Mosby Inc. https://doi.org/10.1016/j.annemergmed.2015.06.031