TPA

35 year old male sudden onset of difficulty speaking and extreme right-sided weakness -- unable to move right arm, facial droop. 3 out of 3 on the Cincinnati Stroke Scale. No prior history of CVA. Mother calls 911. We are there within ten minutes of onset. Quick stair-chair down to the ambulance. We do everything en route -- Vitals, 02 by cannula, IV, Blood sugar check, 12 lead ECG -- notify the hospital of a stroke alert. We are at the hospital within 25 minutes of onset. We are talking to the doctor within 30 minutes. The patient is whisked right off to CAT scan. He comes back with a clean head CT -- no bleeding. The doctor tells the nurse to get the TPA ready. When we come back two hours later, the patient can move his right arm, shake my hand, and while his speech isn't perfect, he can now say his name.

So many times you get called, and the symptoms are hours old or no one can pinpoint the start time or if they can, and its within the window, there is an exclusionary factor. It was great to have a case where it all worked the way it was supposed too.

Did three other calls -- a woman who took a coworker's pepcid and felt quesey, an old man who'd been on the floor since 4:30 the other's day's afternoon and who had horrible cellulitis with weeping sores, and an old woman with dehydration who I had taken in two weeks before for the same problem.