ACUTE STROKE IDENTIFICATION AND TREATMENT (“TIME IS BRAIN”) Andy Jagoda, MD, FACEP Department of Emergency Medicine Mount Sinai School of Medicine New York, New York.
ACUTE STROKEIDENTIFICATION AND TREATMENT (“TIME IS BRAIN”)Andy Jagoda, MD, FACEPDepartment of Emergency MedicineMount Sinai School of MedicineNew York, New York
A 58 yo man experiences one half hour of numbness and weakness in his left arm. When he arrives in the ED his symptoms have resolved. PMH: positive for CAD. Meds: Enalapril. PE: no focal deficits. ECG: NSR.Should this patient be admitted to the hospital?
The patient is discharged for an outpatient workup. Three weeks later he develops left face and arm weakness. EMS is called. Which of the following is the best choice?
a. He should be taken to the closest hospital
b. He should be taken to the closest hospital with a designated stroke team
The patient arrives in the ED, one hour after onset of symptoms, with no improvement. Blood pressure since EMS arrived has remained 170/100. Which of the following is the best blood pressure management?
a. sl nitroglycerin
b. po clonidine
c. iv labetolol
d. no treatment
A CT is obtained within 90 minutes of symptom onset: It is read by a neuroradiologist and shows no signs of edema, infarct, or hemorrhage. Which of the following would you recommend?
d. a plus b or c
e. supportive care
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