For a patient experiencing symptoms of acute ischemic stroke, what should be done regarding fibrinolytic therapy if their INR is below the contraindicated level?

Fibrinolytic therapy is a critical intervention for patients suffering from acute ischemic stroke, particularly when timed within a narrow therapeutic window. The key aspect of this question revolves around the safety and appropriateness of initiating fibrinolytic therapy in light of the patient's INR level.

When a patient's INR is below the contraindicated level, measuring the PT or INR ensures that the patient has an acceptable coagulation status for the administration of fibrinolytics. The guidelines allow for fibrinolysis to be considered based on these coagulation parameters as they help determine the risk of hemorrhagic complications associated with the therapy. Therefore, confirming that the INR is within safe limits sets the stage for executing the therapy responsibly.

This approach emphasizes the importance of patient safety when deciding to administer fibrinolytics. By verifying the INR, the healthcare provider can make an informed decision about the potential benefits and risks of proceeding with fibrinolysis. If the INR indicates a safe threshold, the initiation of fibrinolytic therapy can be warranted.

In summary, considering fibrinolytics after ensuring the INR is below the contraindicated level acknowledges the fine balance between promoting therapeutic efficacy and mitigating the risk of adverse effects, particularly hemorrhage, which is paramount in emergency medicine practice.