What is the drip-and-ship approach to thrombolytic therapy for acute ischemic stroke (AIS)?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

For hospitals with limited access to neurologists or without a stroke center, some small studies indicate that the drip-and-ship approach is efficacious and safe. With the help of video technology or phone consultation with a neurologist at the stroke center, emergency physicians can initiate IV alteplase therapy within the critical therapeutic window, and then transfer patients to another facility for continuation of care. [57]

To provide a national assessment of thrombolytic administration using drip-and-ship treatment paradigm, the authors used data from the Nationwide Inpatient Sample files from October 2008 to December 2009. They found that the drip-and-ship paradigm was associated with higher rates of thrombolytic utilization, supporting the role of this approach as an important strategy to improve the national rate and postadministration care of alteplase use. [58]


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