Table 2.

Reasons for delay in door-to-needle (DTN) time.

Reason for delay in DTN time
Patient was brought in by EMS as a drug overdose
Transfer from free-standing ED and delay in getting INR
Patient unstable
Chest pain and concern for aortic dissection, needed to wait for chest CTA
Patient improved then worsened
Atypical stroke symptoms; needed intubation and repeat CT to rule out bleeding due to worsening neuro symptoms
Chest pain and need to rule out aortic dissection
Neurology delay in calling back
Patient with dementia, unable to give a reliable time of onset
Elevated blood pressure requiring control prior to tPA
Patient initially presented as a drug overdose
Patient presented with a complaint of chest pain initially
Unclear about anticoagulant use (patient with a history of atrial fibrillation)
Patient with waxing/waning symptoms

EMS, emergency medical services; ED, emergency department; INR, international normalized ratio; CTA, computed chest tomography; CT, computed tomography; tPA, tissue plasminogen activator.