Fencing with snake venom

Lots has been said and lots will be said about tPA in stroke. It matters not which side of the fence you trek so long as you acknowledge that there isaonther side (ie. the fence exists). 

Here is a well put critique of the recent AHA/ASA update

It is worthwhile noting that ACEM and ACEP have updated position statements on this subject. Rightly reflecting that clinicians should neither be lulled nor bullied into poor decisions for our patients.

For those who want a concise summary of the opposing view, go to this site. Here's a succinct snapshot for those with less time:

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