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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:



All of the criteria below must be met

    - GCS 10 or >, 



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



3    - Onset of stroke within 7 hours or no symptoms prior to going to bed



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) 



- 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.



- 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.

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