Table 3.
Clinical pathway for acute ischaemic stroke (routinely followed protocols across Pakistan)
| Clinical pathway for acute ischaemic stroke | ||||
|---|---|---|---|---|
| 18. | Please carry out the following orders as appropriate | Yes | No | Date and time |
| 19. | Admit to stroke unit or ICU for 48–72 hours (at a few centres only), then shift to general ward if stable | |||
| 20. | National Institute of Health Stroke Scale (NIHSS)/GCS (individual centre adapted protocols may differ) once/twice daily | |||
| 21. | CT scan of head repeated STAT if decreased level of consciousness or new deficit | |||
| 22. | Monitor vital signs (BP, HR, cardiac rhythm, scores, metabolic acidemia, pulse oximeter (SaPO2) (give oxygen as indicated), Temp and respiratory rate (RR)) | |||
| 23. | Monitor vital signs: every 30×3; every 1 hour×every 6 hours, then every 3 hours×every 10 hours (individual centre adapted protocols may differ) | |||
| 24. | Start mobilisation (in bed or chair) if stable (after functional assessment) | |||
| 25. | Bed rest for 24 hours | |||
| 26. | Keep nothing per oral (NPO) until swallowing screen done (if dysphagia present, keep NPO and repeat screen in 24 hours) | |||
BP, blood pressure; GCS, Glasgow Coma Scale; ICU, intensive care unit; NPO, nothing per oral; SaPO2, scores, metabolic acidemia, pulse oximeter; Temp, temperature.