Protocol 47 - Adult Suspected Stroke 1 - 2.PNG

# Protocol 47: Adult Suspected Stroke **PG 1 of 2** ## Initial Medical Care **Flowchart:** * Perform BOTH Cincinnati Prehospital Stroke Scale* AND Rapid Arterial Occlusion Evaluation (RACE) Scale for Large Vessel Occlusion**. * Identify patients last "known normal". * Identify if patient i...

# Protocol 47: Adult Suspected Stroke **PG 1 of 2** ## Initial Medical Care **Flowchart:** * Perform BOTH Cincinnati Prehospital Stroke Scale* AND Rapid Arterial Occlusion Evaluation (RACE) Scale for Large Vessel Occlusion**. * Identify patients last "known normal". * Identify if patient is on anticoagulants. * Document all findings above. * Do NOT unnecessarily delay transport for procedure. Scene time should be < 10 minutes. * For any abnormal Stroke Scale finding, transport to the nearest most appropriate facility. Do not delay scene time. Initiate rapid transport. **Additional Actions:** * **Blood Glucose:** < 60 or > 400 Refer to ADULT DIABETIC/GLUCOSE PROTOCOL #41 * **12-Lead ECG (if available)** * Refer to other PROTOCOL as indicated: * ADULT COMA OF UNKNOWN ORIGIN PROTOCOL #43 * ADULT SEIZURES/STATUS EPILEPTICUS PROTOCOL #44 **Cincinnati Prehospital Stroke Scale** * **Facial Droop:** * **Normal:** Both sides of face move equally well. * **Abnormal:** One side of face does not move as well as the other side. * **Arm Drift:** * **Normal:** Both arms move the same or both arms do not move at all (other findings, such as pronator drift, may be helpful). * **Abnormal:** One arm does not move or one arm drifts down compared with the other. * **Speech:** * **Normal:** Patient uses correct words with no slurring. * **Abnormal:** Patient slurs words, uses inappropriate words, or is unable to speak. (Have the patient say, "You can't teach an old dog new tricks.") **Revised:** 12/01/24 **Effective:** 05/01/98 **Key:** * **B:** EMT * **P:** Paramedic