BLS STROKE Protocol

I. Scene Size-Up/Initial Patient Assessment

II. Focused History and Physical Exam
A. 0nset/Provocation/Quality /Radiation/Severity/ Time
B. Signs and symptoms
1. Paralysis or weakness on one side of the body
2. Facial droop on one side
3. Altered level of consciousness
4. Change in personality or mood
5. Headache or dizziness
6. Impaired speech
7. Blurred vision
8. Poor coordination
C. Perform a basic stroke exam using the FAST Assessment.
1. Assess for Facial droop: have the patient show teeth or smile
2. Assess for Arm drift: have the patient close eyes and hold both arms
straight out for 10 seconds
3. Assess for abnormal Speech
4. Time last normal

NOTE: If one or more component is abnormal, high probability of stroke. Refer

to stroke destination triage tool. Time from last normal will determine destination.

III. Management
A. Protect patients airway suction as needed
1. Maintain oxygen saturation at a minimum of 95% or if there are signs of
hypoxia.
2. Obtain blood glucose level.
Treat if < than 60 mg/dl
If patient is able to swallow, administer oral glucose, or substance
high in simple sugar; i.e., honey, orange juice with 2-3 tsp. of sugar
B. Check and record vital signs and GCS every 5 minutes

IV. Transport
January 1, 2011

A. Do not delay transport, limit time on scene to <10 minutes

B. Contact Medical Control about where to transport patient.
 ILS STROKE Protocol

I. Scene Size-Up/Initial Patient Assessment

II. Focused History and Physical Exam
A. 0nset/Provocation/Quality /Radiation/Severity/ Time
B. Signs and symptoms
1. Paralysis or weakness on one side of the body
2. Facial droop on one side
3. Altered level of consciousness
4. Change in personality or mood
5. Headache or dizziness
6. Impaired speech
7. Blurred vision
C. Perform a basic stroke exam using the FAST Assessment.
1. Assess for Facial droop: have the patient show teeth or smile
2. Assess for Arm drift: have the patient close eyes and hold both arms
straight out for 10 seconds
3. Assess for abnormal Speech
4. Time last normal

III. Management
A. Protect patients airway suction as needed
1. Maintain oxygen saturation at a minimum of 95% or if there are signs of
hypoxia.
2. Start IV
3. Obtain blood glucose level to rule out low blood sugar as reason for ALOC
Treat if < than 60 mg/dl
Administer Dextrose 50% 25g IV
B. Check and record vital signs and GCS every 5 minutes

IV. Transport
A. Do not delay transport
B. Contact Medical Control about where to transport patient.
January 1, 2011