Physician knowledge of the benefits, risks, and contraindications of tissue plasminogen activator for acute ischemic stroke.

To the Editor: Emergency room (ER) physicians and neurologists are critical in ensuring a prompt evaluation of patients arriving at the ER within 3 hours of symptom onset and in initiating therapy with tPA. Suboptimal institutional readiness for evaluating patients with acute stroke and fear about the hemorrhagic complications among neurologists are some of the factors that can limit the widespread use of tPA, as reported by Katzan et al.1 Family physicians play an important role in educating patients at risk for stroke about the warning signs of stroke and the importance of contacting 911 as soon as these appear. Limited knowledge about the benefits and an unjustified fear of the side effects may limit stroke patients’ access to this treatment. …