Ultra-rapid thrombolysis in 19 minutes: Breaking conventional door-to-needle benchmarks

Abstract

Background: Acute ischemic stroke requires immediate reperfusion therapy to prevent irreversible neuronal injury. Door-To-Needle (DNT) is a key determinant of patient outcome. We report the management of a 73-year-old male who presented within the therapeutic window with right-side weakness and slurred speech. Rapid BEFAST screening and NIHSS assessment triggered institutional code stroke activation. Noncontrast CT excluded intracranial haemorrhage, and intravenous Inj. Tenecteplase was administered. A Door-to-CT time of 6 minutes and Door-To-Needle time of 19 minutes were achieved. The patients NIHSS improved from 11 to 6 without complications. This report highlights the impact of nurse-driven stroke pathways in exceeding recommended DNT benchmarks.