As previously discussed, the time of “last known well” is critical for identifying available treatment options for ischemic stroke (Table 4).
Patients should be screened for inclusion and exclusion criteria for intravenous thrombolytic drugs.
If the patient meets the criteria, then the physician should discuss administration of thrombolytic agents, including the risks and benefits of the therapy.
Emergency departments should have the medication for thrombolysis (Alteplase/recombinant tissue plasminogen activator) readily available because the time window for administration is critical.
Thrombolytic therapy is approved by the Food and Drug Administration for treatment
of ischemic stroke for persons within 0 to 3 hours of last known well for those who meet all inclusion and no exclusion criteria.