Challenges to the implementation of stroke thrombolysis

Abstract

Objectives: Thrombolysis has become the gold standard in the treatment of ischemic stroke that meet specific criteria. While effective, the criteria of suitability are substantial and create an access block for patients. This review seeks to identify the hindrances to the process flow to successful stroke thrombolysis. Methods: A review of literature was done regarding the challenges facing thrombolysis in stroke patients. All English language papers in the subject matter were reviewed and compared with the local situation in the Caribbean especially Trinidad & Tobago. Results: The article presents a review of the American Heart Association’s chain of survival for patients presenting with neurological symptoms suggestive of stroke. The achievable outcomes from this paper will be to describe the potential innovations that can be implemented in the Caribbean to overcome these hindrances. Conclusions: Public health initiatives are an essential part of improving detection. There are many systemic improvements and hospital clinical flow improvements required. It is therefore imperative for health systems managers to appreciate and be aware of all steps in the process given that any impediment abruptly ends the likelihood of successful stroke thrombolysis.