Acute Stroke Bypass Protcol

Question 1

Assess the pt to determine if he/she has has one or more of the symptoms consistent with the onset of an acute stroke, as follows:

Answer 1

a. inappropriate words or mute
b. slurred speech
c. unilateral arm weakness or drift
d. unilateral facial droop, or
e. unilateral leg weakness or drift

Question 2

If the pt meets the criteria listed in paragraph 1 of the Acute Stroke Bypass protocol above,

Answer 2

• Determine if the pt can be transported to a designated Stroke Centre within 6 hrs of a clearly determined time of symptom onset or time pt was last seen in their usual state of health

Question 3

If the pt meets the criteria listed in paragraph 1 & 2 above, assess the pt to determine if they have any of the following contraindications:

Answer 3

a. CTAS 1 and/or an uncorrected airway, breathing or circulation issue
b. stroke symptoms resolved prior to paramedic arrival or assessment
c. Blood glucose level <3 mmol/L
d. seizure at the onset of symptoms
e. GCS <10
f. terminally ill or in pallitative care
g. duration of transport to the designated stroke centre will exceed 2 hrs

Question 4

If the patient doesn’t meet any of the contraindications…

Answer 4

Preform a secondary screen for LVO stroke using the LAMS

Question 5

What should you inform CACC of?

Answer 5

• Inform CACC of the LAMS score to assist in the determination of the closest or most appropriate*** Designated Stroke Centre

Question 6

What happens if patients symptoms improve significantly or resolve during transport?

Answer 6

Continue transport to the designated Stroke Centre