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Stroke Clinical Pathway

1. The document outlines a clinical pathway for stroke patients presenting within 4.5 hours of onset of symptoms. 2. It details the steps to investigate and potentially treat patients with intravenous thrombolytic therapy if they are eligible based on the results of initial labs and CT brain imaging. 3. The pathway also provides general management guidelines and next steps for patients who are not eligible or outside the time window for thrombolysis.

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Kanoknun Pisitpatcaragul
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108 views1 page

Stroke Clinical Pathway

1. The document outlines a clinical pathway for stroke patients presenting within 4.5 hours of onset of symptoms. 2. It details the steps to investigate and potentially treat patients with intravenous thrombolytic therapy if they are eligible based on the results of initial labs and CT brain imaging. 3. The pathway also provides general management guidelines and next steps for patients who are not eligible or outside the time window for thrombolysis.

Uploaded by

Kanoknun Pisitpatcaragul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Name………………Surname………………………

Stroke Clinical Pathway Date of Birth………………………….Age………...


HN…………………….AN…………………………..

Sudden onset of focal neurological deficit with suspicion of stroke

Basic life support ( air way , breathing , circulation )and capillary blood glucose to exclude hypoglycemia

On set < 4.5 hr. On set 4.5 – 72 hrs


Stroke fast track Onset of stroke

Facillites to investigate and


start thrombolytic treatment within 4.5 hours ofter
stroke onset with inform consent (a) Emergency lab :
CBC , BUN , Cr ,
yes No coagulogram Electrolyte ,
EKG
No
Emergency lab :
CBC , BS , BUN , Cr , coagulogram Abillity to transfer to
Electrolyte , EKG appropriate center to obtain thrombolytic
Rx within 4.5 hours

Emergency non contrast Emergency non contrast


Non stroke ( Brain tumor , brain abscess )
CT brain CT brain

Appropriate consultation
Stroke and treatment Stroke

Hemorrhage Normal / hypodensity Normal / hypodensity Hyperdensity


(Hyperdensity ) (Hemorrhage )
General management (b) Ischemic stroke
Appropriate Appropriate
consultation and Consider indications and
Ischemic stroke consultation
treatment contraindications for and treatment
thrombolytic therapy
General management (b)
Intravenous thrombolytic therapy (c)

(a) Thrombolytic treatment for stroke have a chance to risk of bleeding therefore should be clarified
with relatives about advantages and Disadvantages then record to consent form.
(b) General management
- Avoid antihypertensive drug except SBP >220 mmHg / DBP > 120 mmHg
- Avoid intravenous glucose solution
- Control BS 140-180 mg/dl in hyperglycemic patient
-Treatment of concomitant conditions
Reference : WP-PCT-003-00
(c) Should be given patient to stroke unit or ICU unit.

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