Question: How should we abstract thrombolytic administration in the 3 to 4.5 hr timeframe when a reason for not administering existed within 3 hrs?

Patient arrived in ED on 1124 with Time Last Known Well of 0924 (within 2 hour time frame of last known well). t-PA was given at 1323 because physician documents hold t-PA until BP under 180 mm/Hg. How do I answer the question, "Did patient receive tPA?" Do I answer 'No' because t-PA was not given within the 3 hour timeframe but there was a contraindication to giving it documented within 3 hrs?

Answer:

Correct. Select 'No' for "IV Thrombolytic Initiation" and 'Yes' for "Reason for Not Initiating IV Thrombolytic" because the reason preceeded t-PA administration and fell within the 3 hr. timeframe for STK-4. STK-4 does not capture administration beyond 3 hrs.