Article Text

Download PDFPDF
Emergency department-focused thrombolysis for acute ischaemic stroke
  1. Phil Kaye1,
  2. Louise Shaw2,
  3. Barbara Madigan1,
  4. Nicola Jakeman1
  1. 1Department of Emergency, Royal United Hospital, Combe Park, Bath, UK
  2. 2Older People's Unit, Royal United Hospital, Combe Park, Bath, UK
  1. Correspondence to Dr Philip Kaye, Department of Emergency, Royal United Hospital, Combe Park, Bath BA1 3NG, UK; philip.kaye{at}


Acute ischaemic stroke (AIS) is a leading cause of death and disability. Until the 1990s early intervention in AIS was limited to prevention of secondary brain injury. Early thrombolysis has now become standard practice in many areas of the world. Despite the evidence of benefit, the lack of good alternative acute treatments and the recent shift in political focus to stroke management, a thrombolytic strategy for AIS has been very slow to develop in the UK. In this paper, the successful introduction of thrombolysis for AIS through the development of an emergency department-focused process is reported. Obstacles to service development and ways to overcome these are discussed and this therapeutic process is demonstrated to be both possible and self-sustaining in most UK hospitals.

  • Cardiac care
  • thrombolysis
  • emergency care systems
  • emergency departments
  • neurology
  • stroke

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.