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Emergency protocols

tPA reversal · orolingual edema

Record Stroke Time Stamps

Stroke Code

STEP 1 · VITALS
/
mg/dL
Anti-coag/Antiplatelet

Tap Calc to score

Reference only. Verify against patient chart.

STEP 2 · IMAGING

Awaiting Step 1 ↑

STEP 3 · SUMMARY

Awaiting Step 2 ↑

Emergency protocols

Frequently asked questions

What is a stroke code?

A stroke code (or stroke alert) is a rapid hospital response protocol activated when a patient presents with acute stroke symptoms. It mobilizes the stroke team, neuroimaging, pharmacy, and interventional teams simultaneously to minimize time to treatment (door-to-needle <60 minutes for tPA, door-to-puncture <90 minutes for EVT).

What imaging is needed for acute stroke?

Non-contrast CT head to rule out hemorrhage (CT takes ~5 minutes). CT angiography head and neck to detect LVO if EVT candidate. CT perfusion or MRI DWI/FLAIR for extended window patients or when diagnosis uncertain. Do not delay tPA for MRI if CT excludes hemorrhage.

What blood pressure targets should be used in acute ischemic stroke?

For tPA-eligible patients: lower BP to <185/110 mmHg before giving tPA, maintain <180/105 mmHg for 24 hours after. For non-tPA patients: permissive hypertension up to 220/120 mmHg unless other indications. Post-EVT: intensive BP lowering (<130 mmHg) is HARMFUL per 2026 AHA/ASA guidelines; target <180 mmHg.

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