were slow to adopt TPA because it was a big change from what they were used to doing all this rushing around stroke patients there was no treatment they were like the last priority so in the Bay Area that most of the hospitals now are what are called primary stroke centers meaning that they have TPA and they have a plan and then some stroke centers have the comprehensive designation meaning they can go up with catheters and defense you're imaging so in our area we're pretty lucky of it if you call 9-1-1 at this point it's almost