Published: December 2025. Next review: 2030.
This guide provides evidence-based recommendations for delivering intravenous (IV) thrombolysis to adults with acute ischaemic stroke.
It supports clinicians and stroke care teams in NSW to:
- identify eligible patients
- act quickly
- administer treatment safely and consistently.
The guide covers patient selection, timing, dosing (with tenecteplase as the preferred agent), monitoring and managing complications.
It aims to standardise care, reduce variation, and improve outcomes for patients across NSW, including those treated in hospitals supported by the NSW Telestroke Service.
The guide highlights the importance of culturally safe care and shared decision-making with patients, families and carers
Download clinical practice guide (PDF 664.6 KB)
Resources
Published: December 2025. Next review: 2030.
Tenecteplase preparation, administration and dosage (PDF 336.3 KB)
Tenecteplase is the first line and preferred IV thrombolysis agent. This document provides instructions to prepare and administer tenecteplase, and the dosage by weight.
Flow chart (PDF 191.9 KB)
This flow chart outlines the process to follow for IV thrombolysis for adult patients with acute ischaemic stroke, including to identify eligible patients, administer thrombolysis medication and provide post thrombolysis care.