In US hospitals that have been successful, the physicians are waiting as the ambulance pulls up, bloods are usually drawn immediately, an IV is started, the CT scan is already warmed up, they're taken in there and they can be administering the drug, usually within 45 to 50 minutes after arrival in the emergency room. They've been admitted to a country hospital which doesn't have a CAT scanner. However I would point out in some outlying areas in the United States, like Iowa, I know of a situation in which they essentially bring the patients to a central hospital, and using helicopters and ambulances, are able to get them there in a reasonable time. OK so they have the clot-buster. Give me the risks versus the benefits, because I can still talk and I can still understand you, and I want to have this with fully-informed consent.
Strokes are a serious business.
So what you see is to me, a relatively obvious choice for a patient who doesn't want to be in the nursing home and does not want to be disabled. Now take a physician who is normally giving aspirin, giving very benign therapy or reluctantly shrugging his shoulders and having nothing to do for a stroke patient, they are now faced with the dilemma that they're being put in a very proactive situation. They're actually in a risk-taking position. So what they look at is that one of the complications of thrombolytic therapy is actually haemorrhage into the brain. In that net benefit.