Stroke/Intracranial hemorrhage
Base Contact Required
If either of the criteria sets (Ischemic or Intracerebral Hemorrhage) are met and blood glucose is above 60 mg% (or corrected to be above 60 mg%), transport to SNRC. If blood glucose is between 60-80 mg% treat based on field impression:
ISCHEMIC STROKE SUSPECTED:
All of the criteria below must be met
1 - GCS 10 or >,
AND
2 New onset of any one of the following:
- Arm (pronator) drift or unable to raise arm, OR
- Facial paresis (droop), OR
- Slurred or unintelligible speech, OR
- Loss of grip strength, unilateral
AND
3 - Onset of stroke within 7 hours or no symptoms prior to going to bed
INTRACEREBRAL HEMORRHAGE SUSPECTED:
Sudden, severe headache w/ onset in past 7 hrs. with any 1 of the following:
- Vomiting (repeated), OR
- Neuro deficit (hemi-paresis or weakness, gaze to 1 side, or asymmetric pupils w/o prior eye surgery, OR
- Altered mental status, OR
- Marked blood pressure elevation (diastolic > 100 mm Hg)
COMMENTS:
- No oral fluids (OK to give Zofran for nausea/vomiting).
- Monitor/document cardiac rhythm and O2 saturation.
- Establish IV access (NO IO or ext jug) and complete blood glucose analysis.
- Glucagon may be ineffective in reversing hypoglycemic stroke-like symptoms.
- Avoid IO or External Jugular.
DOCUMENT:
- Presence/absence of weakness in arm/leg.
- If patient has history of stroke in past.
- Exact time of onset of stroke symptoms, if known.
- If patient has used any of their own meds immediately prior to or during arrival.
- Document last time seen normal with witness name and phone number, if possible.