Stroke
Summary: <br> Get your attending! <br> <br> <br> <br> Step 1: Obtain Last Known Well<br> <br> <br> <br> * Stroke treatments including tPA and thrombectomy both require last known well* <3-4.5 hours for tPA* <24 hours mechanical thrombectomy<br> <br> <br> <br> Step 2: Finger Stick Blood Glucose<br> <br> <br> <br> * Hypoglycemia is classic mimic of CVA* Results can be obtained immediately<br> <br> <br> <br> Step 3: STAT Head CT Without Contrast<br> <br> <br> <br> * Poor sensitivity for ischemic stroke* Primary use is identification of hemorrhagic stroke* Required prior to administration of tPA!<br> <br> <br> <br> Step 4: Perform NIHSS<br> <br> <br> <br> * Use calculator <a href="https://www.mdcalc.com/nih-stroke-scale-score-nihss">(MDCalc)</a><br> <br> <br> <br> Step 5: Give tPA (If No Contraindications)<br> <br> <br> <br> * Follow department protocol and contraindications* Frequently being updated<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * tPA Basics <a href="http://www.emclerkship.com/intro-to-tpa/">(EM Clerkship)</a>* 2013 AHA Stroke Guidelines <a href="https://www.ahajournals.org/doi/pdf/10.1161/str.0b013e318284056a">(AHA)</a>* NIH Stroke Scale/Score <a href="https://www.mdcalc.com/nih-stroke-scale-score-nihss">(MDCalc)</a><br>
