I gave tPA for the first time ever today. I can not tell you how many strokes/nonstrokes/pretend strokes/the-ER-docs-really-thought-this-was -a-stroke???? that I have seen during my (very long) residency, but this is the first stroke that I’ve had who came to the ER in less than 3 hours and who had no exclusive criteria (there are many) and who didn’t decide to wake up from their drug-induced state of mind just as I was pushing it (idiot. Please do not deny your illicit habits to the one who could kill you!). I was shaking a little, and forgot to unclamp the IV, but it all went okay.

Of course, patient is ancient and crashed an hour after I gave it (unrelated reasons, I think) and I don’t know if [patient] will make it home. But I gave pt a chance–without it, this spunky person would have been bound to a nursing home or wheelchair in the best of situations.

On call again tomorrow. I’m rounding in the ICU tomorrow and have to be there in a short 7 hours from now. So I guess it’s off to bed. Last call for the month, I’m so super excited!