Protocol: STROKE (CVA)

Original Effective Date: 01/01/2001 | Revised Date: 01/25/2010

DESIGNATION OF CONDITION
Signs and symptoms may include any or all of the following: disorientation, weakness or paralysis to one side, excessive drooling, facial drooping, unequal pupils, difficulty in speaking, elevated BP, headache, and/or seizures. Patient may have a past history of CVA or TIA.

EMPHASIS ON PATIENT CARE
Maintain ABCs, including adequate perfusion, oxygenation, and rapid transport.

FIRST RESPONDER AND BASIC PRE-HOSPITAL MANAGEMENT
1. Assess airway, breathing and circulation and manage as indicated.
2. Perform pre-hospital stroke assessment (Cincinnati, Los Angeles, Phoenix).
3. Establish timeline of onset of symptoms.
4. Transport the patient to an appropriate medical facility.
5. Obtain focused H&P - History, physical exam, vital signs.
6. Obtain BGL.
7. Provide early notification to emergency department.

INTERMEDIATE and PARAMEDIC PRE-HOSPITAL MANAGEMENT
Initiate an IV of isotonic solution at a TKO rate or to maintain systolic BP>90 mmHg, enroute.

Prehospital Stroke Scale

Abnormal findings on any part of the exam may indicate an acute stroke.

FACIAL DROOP

Normal:

Both sides of face move equally well.

Abnormal:

One side of face does not move as well as other side.

ARM DRIFT

Normal:

Both arms move the same or both arms don’t move at all.

Abnormal:

One arm doesn’t move or one arm drifts down compared to the other.

SPEECH

Normal:

Patient says correct words without slurring. Ask patient to repeat a phrase such as, “You can’t teach an old dog new tricks”.

Abnormal:

Patient slurs words, says wrong words, or is unable to speak.

 

back to home page