08/14/2013

ACEP Council Resolution on ACEP Policy for tPA use in Stroke

Whereas, the amount of time and body of evidence required to reach consensus is likely inversely proportional to the strength of the supporting information and the need for consensus, and

Whereas, tPA for use in stroke has been around for almost two decades, and the ACEP task force deliberated for many years before any policy could be produced, and

Whereas, although the body of evidence for tPA in stroke continues to grow, there are questions of methodologic validity with much of the literature, and any conclusions have remained persistently controversial, and

Whereas, a substantial subset of Emergency Physicians remain hesitant to use a drug that is as likely to harm as it is to help, and

Whereas, it is not beneficial to the College membership to have a Policy that coerces our colleagues to practice medicine in a way that they continue to be unsure is of benefit to their patients, therefore be it

Resolved, that ACEP should rescind the current "Clinical Policy: Use of Intravenous tPA for the Management of Acute Ischemic Stroke in the Emergency Department," and appoint a task force, charged to evaluate and update this policy based on the current evidence regarding the use of tPA in the setting of acute stroke, and be it further

Resolved, that this clinical policy be open to comment by the ACEP membership for a period of 90 days before consideration for adoption.

Please direct any comments on the proposed resolution to Ohio Chapter President and Councillor, Dr. John Lyman, via the Executive Director at ltiberi@ohacep.org.