Diagnosis and Initial Treatment of Ischemic Stroke. ED Treatment Algorithm.

[See Stroke Code algorithm. A]

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Source: Institute for Clinical Systems Improvement (ICSI). Diagnosis and initial treatment of ischemic stroke. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Feb. 68 p. Diagnosis and Initial Treatment of Ischemic Stroke ED Treatment Algorithm Enters ED via: *Primary care referral. *Walk in. *EMS transport. A = Annotation Neurological deficit present at time of evaluation? See Stroke Code algorithm. A History suggestive of TIA? Out of guideline ED diagnostic evaluation: *CBC. *Glucose. *Electrolytes. *ESR. *Electrocardiogram. *Brain imaging: MRI or CT. A High risk for stroke: *Over age 60. *Diabetes. *Motor weakness. *Speech impairment. *TIA duration 10 minutes or longer. *Acute lesion on DW-MRI or CT. TIA symptoms within 24 hours? High risk for stroke? A Admit to monitored bed. Evaluation: *Carotid imaging: ultrasound, CTA or MRA. *Echocardiogram (if suspect cardioembolic). A TIA symptoms greater than 24 hours and less than 7 days? Rapid outpatient evaluation within 48 hours or admit to hospital. Evaluation: *Carotid imaging: ultrasound, CTA or MRA. *Echocardiogram (if suspect cardioembolic). A Clinic evaluation within 1 week TIA symptoms greater than 7 days All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.