Ischaemic strokes and treatment with thrombolysis: The key lies with paramedics

Paramedics can elicit a crucial piece of information in patients who have suffered a stroke before arrival at accident and emergency—exactly when did symptoms start to occur. This is useful for a crucial treatment to prevent further brain damage from the onset of a stroke.

Doctors quickly to try establish the cause of the symptoms presented by the patient, and if it appears to be a stroke, they are able to diagnose the exact mechanism based on the focal signs the patient are displaying to locate the affected area of the brain, and scans to show radiological evidence of the mechanism in this area whether it be a vessel occlusion or haemorrhage.

This all contributes to selecting the most appropriate treatment. After clinical examination, the initial data gathering investigations to establish that the cause of the patients condition is a stroke are as follows: a full blood count for anemia and leukemia, erythrocyte sedimentation rate for inflammation which could point to temporal arteritis as a cause, urea and electrolytes due to risk of developing hypokalemia (Gariballa et al. 1997) as well as plasma glucose for diabetic complications such as low or high blood sugar manifesting with stroke-like symptoms. An electrocardiogram (ECG) can be performed to detect risks such as atrial fibrillation and rule out a myocardial infarction. Plasma cholesterol is used to determine the risk factors (stroke being increased in patients with high cholesterol levels).