I need some help

  1. My uncle is 46 and had a left side thrombotic stroke a few months ago (April). In December he had a seizure which the doctors deceided it was from ETOH withdraw. He was in the process of quiting drinking. Any way at the hospital the doctors treated him as a seizure even though he had the right side paralysis, expressive aphasia, and every sympton you would think of as a stroke. Even the EMS guys said he thought it was a stoke. Well the ER doctors and nurses were rude putting my aunt off. At the time she asked the nurse if he could possible receive TPA. The nurse said they don't use that any more. Which we found out later that they do. My uncle is just now walking, still no use out of his arm, and you can understand some words. My aunt has all of his records and is researching TPA. Does any body know anything about TPA and if there is a protocal to use it. Anything would be helpful. Thanks
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  2. 17 Comments

  3. by   shygirl
    NurseLKY, Try webmaster@hyperal.com They might be able to help you. I would think TPN is ordered for pt.'s,who are unable to have proper nutrition for what ever reason. That's pretty sh---- of the hospital. Sorry about your uncle. Is he getting O.T. & P.T. to regain what he has lost? Gilda
  4. by   Huganurse
    I don't know about KY, ER docs and nurses are covered under the good samaritan act. They are not held liable for anything that happens in the ER. Sometimes it's just best to move on with your life and be positive of full recovery through rehab than it is to harp and get depressed about what is already done. How is learning about TPA going to help your Uncle now?
    Last edit by Huganurse on Jun 30, '02
  5. by   Nurse Ratched
    Amy - check out www.google.com and type in TPA stroke for some info. Gives you sites with different clinical guildelines for using TPA. If the stroke was misdiagnosed from the start, they then missed the window for using it.

    Just out of curiosity - was your uncle actively withdrawing from alcohol at the time of the stroke as he was at the time of the previous seizure?
  6. by   Heather56
    So sorry to hear about your father but it sounds like he is doing okay. I work in Neuro med/surg and work with lots of stroke patients. TPA in our hospital, Victoria, BC is given only under a strict set of conditions such as
    less than 4 hours from onset of symptoms
    confirmed thrombolytic stroke (unfortunatly many drinkers and former drinkers have strokes from bleeds)
    age, other health problems and on and on.
    I agree with Huganurse, it's time to focus on the future and try not to dwell on the past. Also I have seen all sorts of outcomes from patients wether or not they had TPA.
    Good luck
  7. by   Heather56
    oops, sorry it was your Uncle. Also I just like to add that the men we see under 50 usually do quite well.
    Heather
  8. by   ERNurse752
    There is a protocol to use it, but there is an extensive list of criteria you have to meet before you can give TPA. Some places have other drugs now they use instead of TPA.
    Don't really know enough about the situation to be able to say if he would have qualified for TPA or any other similar drug or not.
    Hope he continues to improve
  9. by   jevans
    NusreLKY

    Hi I am a Stroke Nurse in the UK. TPA is not used routinely here for Stroke as CT scans are difficult to get and would be out side therapeutic window

    To be quite fair it is a very dangerous drug to give with some awful side effects- cerebral bleed being one of them

    Now I can'y speak for your uncle's docs but I would imagine this is probably reason for not giving

    Seizures post stroke can occur depending where the clot and infarct has occurred

    April is very soon and- early recovery of movement is encouraging for the future.

    He needs to find a physio that specialises in stroke, as their expertise is not found in general physio

    Please remember that stroke is the most dreadful assault to the human body.

    the result= its devastation affects mind body and soul

    Both him and his wife are dealing with bereavement for his future self uncertain about the future.

    Check out-

    www.bmj.com

    The American heart and stroke society

    www.arn.com

    these sites have great info

    Please contact me if you would like further info

    Best wishes
    j
    Last edit by jevans on Jun 26, '02
  10. by   NRSKarenRN
    Stroke: Prevention and Treatment - Age Page - Health Information
    ... Stroke: Prevention and Treatment. Stroke is the third leading cause of death in the United States after heart disease and cancer. ...
    www.nia.nih.gov/health/agepages/stroke.htm

    Links to Professional info, stroke clinical trials + drugs.
    Includes use TPA
    http://www.stroke.org/admin/pdf/out/firsthours.pdf
  11. by   NurseLKY
    Thanks for all the information. He was clean from the ETOH since December. The reason we are dwelling on the past is that something should have been done. The ER nurses and doctors just left him in the room for hours with out anybody checking on him. I talked to the doctors at the hospital i worked at and new onset of stroke symptoms are treated here as a Room 9 our version of major trauma or emergency. Now why couldn't he have received the same sort of care there. Even his neurologist now said he should have received the TPA. So we are looking into maybe a law suit. We aare just getting all the information first before wedo that though thats why allthe questions about TPN. He goes to PT, OT, and speach 3 times a week but insurance will only pay for a few more weeks. My aunt has had to quit her job to take care of him. Maybe this all could have been avoided if he got the right care.
  12. by   zudy
    NurseLKY the American Heart Association has ACLS protocols regarding the TPA for CVAs. I think that one of their books for ACLS should answer many of your questions. Good luck to your uncle and all your family. Zudy
  13. by   sunnygirl272
    gilda...TPA=Tissue Plasminogen Activator
  14. by   sunnygirl272
    NurseLKY, try doing a medline search through medscape...free, but you willneed to register/setup an account..

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