Prior to making any medical decisions, please view our disclaimer.
This protocol was developed and approved by the multidisciplinary Acute Stroke Quality
Taskforce and outlines the major responsibilities for the urgent evaluation and treatment
of acute stroke patients who present to the ED.
Please refer to other guidelines for
the management of inpatients with acute stroke symptoms, or those who present between
6 to 12 hrs after onset of symptoms.
Activate the Acute Stroke Protocol for all patients who were Last Seen Well less than 8
hours before ED arrival with acute neurological symptoms. In cases with fluctuating
symptoms, those with complex issues, or who are possible research subjects, the
protocol should also be activated.
The following chart, which outlines the Time Targets mentioned in the Primary Stroke Service Regulations, is included to help
hospitals assess the timeliness of activities related to stroke evaluation and diagnosis.
Some of the activities listed below will occur concurrently, and the
Department of Health recognizes actual individual timeframes may vary,
however the goal for the initiation of IV t-PA remains at one hour from
the time of patient arrival in the ED.
The protocol is divided into the following sections:
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This video simulation of an Emergency stroke evaluation
illustrates the care of patients with acute stroke by the
MGH Acute Stroke team.
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