Date of Award

Spring 2017

Degree Type

Honors Project



First Advisor

Gerald Ballough

Second Advisor

Vincent Kling


The emergency department is often the frontline of medical treatment for a wide variety of disease and injury including ischemic strokes or CVA. Intravenous tissue plasminogen activator or tPA is the internationally accepted treatment for acute ischemic strokes and can minimize neuronal tissue death if administered appropriately and is more effective when administered closer to acute onset of symptoms. The American Stroke Association recommends tPA to be administered within an hour for the best results and tPA is not recommended to be administered beyond 4.5 hours. Emergency departments are constantly developing new and more efficient protocol to maximize the amount of patients eligible for thrombolytic treatment. Per current research, streamlined code stroke type protocol is the most effective and most widely available emergency department stroke protocol with median door-to-needle times of 20 minutes. Despite the protocol put in place, the goal of all emergency departments is to administer tPA within the 60-minute recommended window to minimize risk and potential neuronal death.