Medication errors are frequent in intensive care units, and while high-quality evidence is limited, strategies such as medication reconciliation, pharmacist participation, and standardization may improve patient safety.
Introduction We sought to evaluate the impact of pretreatment with intravenous thrombolysis (IVT) on the rate and speed of successful reperfusion (SR) in patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT) in a high-volume tertiary care stroke center. Methods Consecutive patients with ELVO treated with MT were evaluated. Outcomes were compared between patients who underwent combined IVT and MT (IVT+MT) and those treated with direct MT (dMT). The elapsed time between groin puncture to beginning of reperfusion (GPTBRT) and the numbers of device passes required to achieve SR were also documented. Results A total of 287 and 132 patients were treated with IVT+MT and dMT, respectively. The IVT+MT group had higher SR (73.8% vs 62.9%; p=0.023) and 3-month functional independence (modified Rankin Scale score 0–2;51.6% vs 38.2%; p=0.008) rates. The median GPTBRT was shorter in the IVT+MT group (48 (IQR 33–70) vs 70 (IQR 44–98) min; pConclusions IVT pretreatment appears to increase the rates of SR and shortens the duration of the endovascular procedure by requiring fewer device passes in patients with ELVO treated with MT.
Camiré et al. (2009) conducted a review in Medication errors in critical care. Medication error prevention strategies (e.g., medication reconciliation, pharmacist participation, computerized order entry) was evaluated. Medication errors are frequent in intensive care units, and while high-quality evidence is limited, strategies such as medication reconciliation, pharmacist participation, and standardization may improve patient safety.