Step 5: ACLS Stroke Protocol
Head CT Scan emphasis:
Within the ACLS stroke protocol, the head CT scan is the primary intervention that needs to take place. The head CT will provide you vital information regarding the nature of the patients symptoms, and this information will direct your course of treatment.
The head CT scan should take place within 25 minutes of the patients arrival to the emergency department and should be read by a qualified physician within 45 minutes of arrival.
Decision Point: Yes Head Bleed or No Head Bleed
The CT scan is used to determine if there is any intracranial hemorrhage (bleeding) present in the brain prior to treatment. If a hemorrhage is present, the patient will not qualify for fibrinolytic therapy since the use of fibrinolytic therapy would worsen any existing bleeding.
If there is no intracranial hemorrhage present the patient may qualify for fibrinolytic therapy, and you would move on to the next step toward fibrinolytic therapy in the stroke algorithm.
Do not give any anticoagulants before ruling out intracranial bleeding. (anticoagulant example: aspirin, heparin, or any fibrinolytic)