The key time intervals for acute stroke care in the ED:
- Initial evaluation within 10 minutes of arrival
- Notify stroke team within 15 minutes of arrival
- CT imaging within 25 minutes of arrival
- CT scan interpretation within 45 minutes of arrival
- Door-to-needle time for IV rt-PA within 60 minutes of arrival
Blood pressure goals for ischemic stroke in the emergency department (for those patients eligible for thrombolytic therapy) is to keep systolic <185 mmHg and diastolic <110 mmHg. Keep in mind that prehospital treatment of blood pressure in the stroke patient is not recommended. The blood pressure should be managed after rt-PA has been given and kept below 185/105 for the next 24 hours. [34]
