Module 10
Stroke
Rapid recognition, prehospital notification, and time-critical imaging and treatment.
Rapid Recognition
- Use a validated stroke scale (e.g., NIH Stroke Scale / FAST-ED).
- Recognize: facial droop, arm drift, speech changes, sudden vision loss, balance/gait changes.
- Prehospital notification: alert the receiving hospital before arrival to activate the stroke team.
Time-Critical Imaging
1
Non-contrast CT scan within 20 minutes
Rule out hemorrhage before considering thrombolytics.
2
If no hemorrhage AND within treatment window
Assess eligibility for IV thrombolytics.
3
Consider thrombolytics
IV alteplase (tPA) for eligible patients within the time window.
4
Consider endovascular therapy
Mechanical thrombectomy for large vessel occlusion.
Clinical Pearl
The non-contrast CT must be completed within 20 minutes of arrival — 'time is brain,' and treatment windows are absolute.
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