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Dosing Tissue Plasminogen Activator on a Mobile Stroke Unit: Comparison Between Estimated and Hospital-Measured Weights
- Source :
- Journal of Neuroscience Nursing. 53:166-169
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- BACKGROUND: Prehospital tissue plasminogen activator dosing in a mobile stroke unit (MSU) is estimated by the paramedic and nurse. We aimed to determine the accuracy of the estimated weight method compared with the actual weight of patients treated with tissue plasminogen activator on the MSU. METHODS: We prospectively collected the estimated weight used on the MSU for treatment and the first-documented hospital-measured weight (bed scale) within 24 hours of hospital arrival. Median absolute and percent difference in weights were calculated; less than 10% of difference in weights was considered acceptable. To compare the estimated and measured weights, we conducted a Wilcoxon signed rank test and Fisher exact test to explore the association between weight difference of greater than 10% and patient outcomes. RESULTS: Among 337 patients, median estimated and hospital-measured weights were 79.0 kg (interquartile range [IQR], 66.0-94.5) and 78.5 kg (IQR, 65.0-91.7), respectively. The median of the absolute value of the difference in estimated versus measured weight was 2.7 kg (IQR, 0.6-7.6; P < .0001). The median percent difference in weight was 3.6% (IQR, 0.8%-9.4%). The median difference between the tissue plasminogen activator dosage administered on the MSU and the recommended dose based on the actual weight was 1.3 mg (IQR, 0.06-4.8) in absolute value. In 56 patients (16.6% of the entire sample) with overestimation of weight by greater than 10%, there were no symptomatic intracerebral hemorrhages. There was no association between weight difference and discharge modified Rankin score (P = .59). CONCLUSION: Weight estimation on an MSU can lead to similar tissue plasminogen activator dosing for 83.4% of subjects compared with if dosing were determined based on actual weight. Weight overestimation or underestimation had no detected impact on tissue plasminogen activator outcomes.
- Subjects :
- medicine.medical_specialty
Estimated Weight
Urology
030204 cardiovascular system & hematology
Tissue plasminogen activator
Weight difference
Brain Ischemia
Actual weight
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Fibrinolytic Agents
Interquartile range
medicine
Humans
Thrombolytic Therapy
Dosing
Stroke
Fisher's exact test
Endocrine and Autonomic Systems
business.industry
Body Weight
medicine.disease
Hospitals
Medical–Surgical Nursing
Treatment Outcome
Tissue Plasminogen Activator
symbols
Surgery
Neurology (clinical)
business
Mobile Health Units
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 19452810 and 08880395
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Journal of Neuroscience Nursing
- Accession number :
- edsair.doi.dedup.....c96cb025c411afe95eb662c30a99ed15