Patients with the following conditions are excluded from measure denominator:
• Expired in the ED
• Allergic reaction to alteplase, streptokinase, anistreplase, tenecteplase, or reteplase
Within 90 days before start of ED encounter:
• Ischemic stroke
• Significant facial and/or closed head trauma
• Peptic ulcer
• Intracranial or intraspinal surgery
Within 21 days before end of ED encounter:
• Major surgery
Within 24 hours before start of ED encounter and during ED encounter:
• Suspected aortic dissection
• Severe neurologic impairment
• Mechanical circulatory assist device placement, including: aortic balloon pump, biventricular assist device, intra-aortic balloon, intra-aortic balloon counterpulsation, intra-aortic counterpulsation balloon pump, left ventricular device, percutaneous ventricular assist device, or ventricular assist device
• Intubation, including endotracheal intubation, mechanical ventilation, nasotracheal intubation, or orotracheal intubation
• Cardiopulmonary arrest, including: cardiac arrest, CPR, defibrillation, respiratory arrest, or ventricular fibrillation (V-fib), ventricular tachycardia (VT), or pulseless electrical activity (PEA); or, traumatic or prolonged (>10 minutes) CPR
At the start of ED encounter:
• Bleeding or bleeding diathesis (excluding menses)
• Known malignant intracranial neoplasm (primary or metastatic)
• Known structural cerebral vascular lesion (e.g., AVM)
• Advanced dementia
• Pregnancy
• Active oral anticoagulant therapy
|