Stroke assessment and management in pre-hospital settings

This article will review the assessment and management of acute stroke in the pre-hospital setting. Stroke affects over 111,000 individuals per year, with almost 1 million individuals living with the after effects of stroke in England today. 85% of all strokes are ischaemic, treatments including with intravenous thrombolytic agents and mechanical thrombectomy, the remaining 15% haemorrhagic strokes are able to managed with decompressive hemicraniectomy. The key risks factors for stroke will also be briefly discussed, since they are commonly presenting conditions in the pre-hospital setting. A range of specific stroke assessment tools will be presented – not all are used, nor appropriate, for the pre-hospital setting – but it is useful to be aware of these. The article will also include differential diagnosis and stroke mimics. The key features of acute stroke are the sudden onset of focal neurological sings and symptoms.

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