[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-370078-105":3,"doc-detail-370078-en":81,"detail-sidebar-cat-0-en-105":99},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","emergency-neurological-life-support-acute-ischemic-stroke-protocol-version-50","Emergency Neurological Life Support Acute Ischemic Stroke Protocol - Version 5.0","","Emergency Neurological Life Support acute ischemic stroke protocol outlining the acute ischemic stroke algorithm, including checklist and communication items for rapid assessment. Provides guidance on IV thrombolysis candidate evaluation, endovascular treatment considerations such as mechanical thrombectomy, hospital admit or transfer decisions, and management pathways based on timing, ABCD2 risk stratification for TIA, NIHSS, and imaging findings (CT/CTA/CTP). Includes sample sign-off narratives and dosing-related administration time documentation expectations for thrombolytics, plus blood pressure targeting and criteria for when neither IV nor endovascular therapy is appropriate.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/emergency-neurological-life-support-acute-ischemic-stroke-protocol-version-50/370078/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/emergency-neurological-life-support-acute-ischemic-stroke-protocol-version-50/370078.png","ImageObject",300,407,{"name":42,"@type":43},"Riley West","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information should clinicians collect during acute ischemic stroke evaluation?","Question",{"text":63,"@type":64},"The protocol checklist emphasizes activating the stroke code (if available), recording vital signs, determining time of onset/last known well (LKW), obtaining NIHSS, ordering CT/CTA, and reviewing medication history with focus on anticoagulants and last administration time.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"When is IV thrombolysis considered, and what key blood pressure criteria apply?",{"text":68,"@type":64},"IV thrombolysis candidacy is determined using the protocol’s pathway, including assessing whether BP exceeds 185/110 mmHg and applying conditions based on the patient’s onset window and treatment eligibility.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the protocol guide endovascular treatment decisions?",{"text":72,"@type":64},"For endovascular therapy, the protocol calls for considering mechanical thrombectomy and documenting relevant procedure timing such as time to groin puncture, along with recanalization and TICI score assessment.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},370078,1790241415,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":4,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":92,"language":93,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":94,"faqs":95,"seo_title":96,"seo_description":12,"update_tm":97,"read_time":98},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc",7,"Emergency Neurological Life Support Acute Ischemic Stroke Protocol  \nVersion 5.0  \nAuthors  \nArchana Hinduja, MD Jessica L. Carpenter, MD M Sohel Ahmed, MD Last updated: May 2022  \nProtocol developed by: Archana Hinduja  \nAcute Ischemic Stroke Algorithm  \nChecklist & Communication  \n~~ ~~ Acute Ischemic Stroke Table of Contents ~~ ~~  \nAcute Ischemic Stroke Algorithm ................................................................................................ 1  \nChecklist ......................................................................................................................................3  \nCommunication ...........................................................................................................................3  \nAcute Ischemic Stroke ................................................................................................................5  \nIV Thrombolysis Administration ...................................................................................................6  \nOnce a patient is deemed a candidate for IV thrombolytics ....................................................6  \nEndovascular Treatment .............................................................................................................7  \nConsider mechanical thrombectomy .......................................................................................7  \nHospital Admit or Transfer ..........................................................................................................8  \nWhile waiting for ICU bed ........................................................................................................8  \nConsider patient transfer if: .....................................................................................................9  \nLow Risk TIA ............................................................................................................................. 10  \nABCD2 Score 0-3 ................................................................................................................... 10  \nNo thrombolysis unless BP is reduced...................................................................................... 11  \nBlood pressure (BP) exceeds 185/110 mmHg ...................................................................... 11  \nHigh Risk TIA ............................................................................................................................ 12  \nTIA risk moderate or high, or unable to arrange timely outpatient work-up and follow-up .... 12  \nOnset Less Than 3 hours .......................................................................................................... 13  \nTime from stroke symptom onset is less than 3 hours .......................................................... 13  \nOnset Between 3 and 4.5 Hours ............................................................................................... 16  \nTime from stroke onset is between 3 and 4.5 hours .............................................................. 16  \nPatient improves following thrombolysis ................................................................................... 17  \nMeasurable improvement within 1 hour? LVO Present or Suspected ................................... 17  \nYes-Patient is an IV thrombolysis Candidate .......................................................................... 18  \nIs Blood Pressure (BP) less than 185/110 mmHg? ............................................................... 18  \nNo: Patient is not an IV Thrombolysis or IA Treatment Candidate ............................................ 19  \nNeither IV thrombolysis or Endovascular intervention is appropriate .................................... 19  \nSymptom Onset > 4.5 hours .....................................................................................................20  \nOutside IV thrombolysis window............................................................","cbCaiee7kZ6yeWYe","https://ap.wps.com/l/cbCaiee7kZ6yeWYe","pdf",380937,23,"English","# Acute Ischemic Stroke Algorithm\n## Checklist\n## Communication\n# Acute Ischemic Stroke\n## IV Thrombolysis Administration\n## Endovascular Treatment\n## Hospital Admit or Transfer\n## Low Risk TIA\n## High Risk TIA\n## Onset Less Than 3 hours\n## Onset Between 3 and 4.5 Hours\n## Symptom Onset > 4.5 hours","[{\"question\":\"What information should clinicians collect during acute ischemic stroke evaluation?\",\"answer\":\"The protocol checklist emphasizes activating the stroke code (if available), recording vital signs, determining time of onset/last known well (LKW), obtaining NIHSS, ordering CT/CTA, and reviewing medication history with focus on anticoagulants and last administration time.\"},{\"question\":\"When is IV thrombolysis considered, and what key blood pressure criteria apply?\",\"answer\":\"IV thrombolysis candidacy is determined using the protocol’s pathway, including assessing whether BP exceeds 185/110 mmHg and applying conditions based on the patient’s onset window and treatment eligibility.\"},{\"question\":\"How does the protocol guide endovascular treatment decisions?\",\"answer\":\"For endovascular therapy, the protocol calls for considering mechanical thrombectomy and documenting relevant procedure timing such as time to groin puncture, along with recanalization and TICI score assessment.\"}]","Emergency Neurological Life Support Acute Ischemic Stroke Protocol - Version 5.0 | PDF",1790186614,58,{"code":4,"msg":82,"data":100},[101,105,109,113,118,123,126,131,135,138,142],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},"Exam",70,"exam",{"id":114,"doc_module":4,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},5,"Comic",60,"comic",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":124,"slug":125},40,"healthcare",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":129,"slug":130},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":133,"slug":134},"Religion & Spirituality",20,"religion-spirituality",{"id":133,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":133,"slug":137},"World Cup","world-cup",{"id":139,"doc_module":4,"doc_module_name":25,"category_name":140,"show_sort_weight":139,"slug":141},10,"Lifestyle","lifestyle",{"id":143,"doc_module":4,"doc_module_name":25,"category_name":144,"show_sort_weight":114,"slug":145},19,"General","general"]