How to Call
If you suspect your patient is having an acute stroke, call the operator at 8888.
State “Brain Attack”, give the patient location, and give your name.
Remember: Time Lost is Brain Lost
Acute Stroke Signs and Symptoms
- Sudden weakness or numbness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
- Initiate a Brain Attack if your patient has onset of these symptoms within 6 hours.
It is important to accurately determine time of symptom onset. If the exact time is unknown, the time of onset is considered the time the patient was last seen without symptoms. If a patient wakes with symptoms, the time of symptom onset is when they went to sleep.
Intravenous tPA Inclusion and Exclusion Criteria
- Inclusion criteria: Diagnosis of ischemic stroke causing measurable, persistent neurological deficit. Onset of symptoms ≤ 3 hours to start of infusion.
- Exclusion Criteria:
- CT evidence of intracranial hemorrhage or multi-lobar infarction (hypodensity > ⅓ cerebral hemisphere)
- HTN > 185 mmHg systolic and > 110 mmHg diastolic despite treatment
- Prior intracranial hemorrhage
- Head trauma, myocardial infarction, or stroke in previous 3 months
- Rapidly improving deficits (suggestive of TIA)
- Pregnant or lactating female
- INR ≥ 1.7, PTT >34
- Major surgery or trauma within 14 days
- Seizure associated with stroke onset
- Platelet count < 100,000
- Arterial puncture or LP within 1 week
- GI or urinary bleeding within last 3 weeks
Assure inclusion and exclusion criteria met prior to infusing tPA.
