IST-3 Frequently Asked Questions

Participation

•   Centre requirements
•   CT and MR Scan requirements (Powerpoint presentation)
•   Image Transfer Guidelines
•   Image Transfer Form
•   Example of Registration Form to Confirm Trial Centre Eligibility
•   Patient Eligibility
•   Consent
•   How to seek Consent for IST-3 - new power point presentation
•   Poster showing consent trends in trial
•   Treating a patient within the licence? - details at - http://www.acutestroke.org

If a patient has a clear indication for thrombolytic treatment with rt-PA, and you therefore plan not to randomize in IST-3, but to treat within the licence, you are encouraged to register such usage with the SITS register - follow the link above for details

Useful Posters

•     IST-3 Trial Poster (in pdf format)
•     Poster to encourage recruitment - display in emergency dept.
•     Poster to alert staff to a stroke admission - 1
•     Poster to alert staff to a stroke admission - 2

Randomisation decisions

• Trial FlowChart  
• Details of some complications of rt-PA therapy for stroke
•    Link to American Stroke Association's Online NIH Stroke Scale Training Program
• llbs/Kilos Conversion Chart
• Weight/Dosage Chart
• Plasma Glucose Conversion Chart
• Is it OK to randomise a patient with a seizure at onset?  
• My patient had a little stroke last week and another bigger stroke today, is it OK to randomise them?
• My patient had a stroke in the right hemisphere, and I am not sure that they are aware of stroke onset - what should I do?
• Is there an upper limit to blood pressure for patients being considered for the trial?
• My patient is in a coma, with a Glasgow coma scale of 3 and the scan shows a small 'infarct' in the temporal lobe - can I randomise them?
• The summary of produce characteristics for rt-PA says that patients with a history of prior stroke and diabetes should not be treated.

Nursing Care and IST- 3

•     A Typical Nursing Protocol for IST- 3
•     Nursing Pathway Summary for IST- 3
•     Thrombolysis for Acute Ischaemic Stroke:Core Nursing Requirements
       This article was published in the British Journal of Nursing (Volume 12 Number 7: 393-452)
•     Nurse Feedback - Let's hear your views and experiences
•    
• Link to National Stroke Nursing Forum
•  

Link to Scottish Stroke Nurses Forum

            Link to The Stroke Association website

Events during treatment

• What to do if you suspect an anaphylactoid reaction as a result of rt-PA? 
  
  
   

• Anaphylaxis Pathway
   

• What to do if you suspect intracranial bleeding as a result of rt-PA?
  
  

• What to do if you suspect extracranial bleeding as a result of rt-PA?
  
  
   

• What to do if your patient is hypertensive and a candidate for rt-PA?