Step 2: ACLS Stroke Protocol - Learn & Master ACLS/PALS

Comments

  1. aslan says

    Jeff
    If time zero cannot be established, will this exclude the patient from fibrinolytic therapy even if he meets all other requirements?

    • Jeff with admin. says

      Yes if it cannot be established at all then the patient would be excluded from fibrinolytic therapy. However, usually and realistically it can be established or at least approximated.

      It is the physician’s discretion to realistically approximate given the history of the case. A physician could override a time if he thought there was any chance that the time limit was not exceeded significantly

      Kind regards,
      Jeff

  2. Ita Sunday says

    I did not hear you talk about B.P check while carrying out prehospital stroke intervention. Isn’t necessary?

    • Jeff with admin. says

      The vital signs are not discussed here since they are a necessary part of the standard assessment for any patient no matter what their condition may be. Focus of these pages in strictly on Stroke protocol and assessment. Whether the patient’s blood pressure is high or low will not determine the course of stroke treatment. In the case where a patient is critical and needs ACLS intervention then you would use ACLS protocol in parallel with the ongoing stroke protocol.
      Kind regards,
      Jeff

  3. Nguyen Van Truong says

    When we see a victim with suspected of stroke? what is the best technique to move the patient? in condition that there is no equipment to transfer him we can bear him on shoulder or back?

    • Jeff with admin. says

      If there is no evidence of trauma, a stroke victim can be moved as you would move any patient to ensure safety during transfer. The level of severity of the stroke would dictate to you how many people would be necessary for safety with any type of transfer. In normal circumstances EMS should perform transfers and therefore bearing a patient on your shoulder or back would not be necessary. In a situation where EMS services are not available, you would want to work toward ensuring the safety of the patient and any provider that is performing the transfer.
      Kind regards,
      Jeff

      • Truong says

        Thank you very much for your reply, actually i am living in developing country Viet Nam where EMS is not available and Medical staff is not always ready to pick up patient as well, so most of the time family member must take patient to hospital. Therefore, i am just wondering about how the method of transfer can influence the condition of patient such as get worse significantly or not.

      • Jeff with admin. says

        The method of transfer should not have any significant influence on the condition of the patient. Method of transfer should not make the patient any worse. The most important aspect is to reduce the time from stroke onset to initiation of fibrinolytic therapy.

        Kind regards,
        Jeff

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