Administering Intravenous Alteplase (Tissue Plasminogen Activator [tPA])

Step 1: Eligibility-The eligibility criteria for patients with acute ischemic stroke within 3 hours of symptom onset include: • An adult (> 18 years of age) • Exclusion of intrancranial hemorrhage by an imaging technique sensitive for the presence of hemorrhage • Arrives at the emergency department in time to be treated within 3 hours of symptom onset • The recommended dose of IV tPA is 0.9 mg/kg (not to exceed 90 mg total dose) infused over 60 minutes with 10% of the total dose administered as an initial bolus over 1 minute • The goal for treatment of IV tPA is to give bolus and initiate infusion to eligible patient in less than 60 minutes of patient arrival • See attached information regarding close observation and frequent monitoring of patients for neurologic changes, any signs/symptoms of intracranial hemorrhage, and any signs of adverse drug reactions are important during patient recovery.