Management of Suspected Stroke

Management of Suspected Stroke - Flowchart Management of Suspected Stroke Management of Suspected Stroke

Flowchart

Suspected stroke: Abrupt or rapid onset of a focal neurological deficit or coma

Specific treatment according to pathology
Seek advice from neurosurgeon
Start nimodipine if subarachnoid haemorrhage (Chapter 67)
Measures to reduce intracranial pressure if indicated (Chapter 72)

Chapter 67
Chapter 72

End

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Stabilize airway, breathing and circulation
Correct hypoglycaemia

Table 1.1

Focused assessment (Tables 65.1 and 65.2)
Immediate CT/MRI
Other urgent investigation (Table 65.3)
Refer to stroke physician

65.1 65.2

Table 65.3

CT/MRI

Normal/acute infarction

Haemorrhage

Mass lesion

Thrombolysis if inclusion/exclusion criteria are met (see text and Table 65.6)

Consider thrombectomy if thrombolysis ineffective
Antiplatelet therapy (see text)

Transfer to stroke unit
Supportive care

Thrombolysis if inclusion/exclusion criteria are met (see text and Table 65.6)

Consider thrombectomy if thrombolysis ineffective
Antiplatelet therapy (see text)

Transfer to stroke unit
Supportive care

Thrombolysis if inclusion/exclusion criteria are met (see text and Table 65.6)

Table 65.6

Consider thrombectomy if thrombolysis ineffective
Antiplatelet therapy (see text)

Transfer to stroke unit
Supportive care