Stroke pathway

ENLS acute ischemic stroke protocol

 Acute ischemic stroke checklist for the first hour

 Labs: CBC, platelets, chemistries, PT/PTT, glucose

 IV access
 Supplemental oxygen to maintain sats >94 %
 Activate stroke code system (if available)
 NIHSS
 Administer t-PA if eligible
The clinical suspicion of stroke
algorithm assumes the patient
is outside of the hospital when
stroke occurs. Based on the
results of
brain imaging, the patient can be
triaged to one of the three ENLS
protocols shaded in gray
(bottom)
Risk of intracerebral hemorrhage with IV t-PA treatment
Risk of intracerebral
NIHSS score
hemorrhage (%)
0–10 2–3
11–20 4–5
>20 17