Background The Froedtert Acute Stroke Team (FAST) is composed of various health professionals who respond to stroke calls, but it does not formally include a pharmacist at this time. However, emergency department (ED) pharmacists have been actively involved in patient evaluation and facilitation of intravenous recombinant tissue plasminogen activator (rtPA) preparation and administration in the ED. ED Pharmacists are qualified to dose and prepare rtPA, as well as screen for contraindications to therapy. Objective The primary objective was to compare the accuracy of rtPA dosing, average door-to-rtPA time and identification of contraindications to rtPA therapy when a pharmacist was present versus absent in the ED. Methods This is a retrospective study of 105 patients who received rtPA for acute ischemic stroke in the ED at a comprehensive stroke center from January 1, 2008 to October 1, 2012. Results A total of 105 patients were included in this study. Dosing accuracy was similar when a pharmacist was present versus absent (96.6% vs. 95.6%, p=0.8953). The median door-to-rtPA time when a pharmacist was present was statistically significant shorter than when a pharmacist was absent (69.5 minutes vs. 89.5 minutes, p=0.0027). When a pharmacist was present, a door-to-rtPA time of less than 60 minutes was achieved 29.9% of the time, as compared to 15.8% in the pharmacist absent group (p = 0.1087). Conclusion Pharmacist involvement on stroke teams may have a beneficial effect on door-to-rtPA time and patient care in the ED.

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