ACS Sepsis Stroke Trauma GI bleed DKA Anaphylaxis Pregnancy trauma Child sepsis Status epilepticus APO HyperK

Acute stroke (code stroke)

Start this sheet when: New focal deficit (BE-FAST: balance, eyes, face, arm, speech) with last known well within 24 hours. Check glucose first; hypoglycaemia is the commonest mimic.

Hospital (remembered on this device)Patient ID / UHID (not saved)Age / SexFilled by

Door dateDoor time (clock starts here)

Last known well (clock time)

Time since door

Lysis window (4.5 h): enter last known wellThrombectomy window (24 h): enter last known well

Targets met --Breaches 0

1.Doctor at bedside, glucose and NIHSS done
≤ 10 min from door · AHA/ASA 2026: 10 min
Enter door time
2.CT scan started
≤ 25 min from door · AHA/ASA 2026: 25 min
Enter door time
3.CT (and CTA) read and reported
≤ 45 min from door · AHA/ASA 2026: 45 min
Enter door time
4.Thrombolytic bolus given: door-to-needle(Lysis-eligible)
≤ 1 h from door · AHA/ASA 2026: 60 min, aim for 30
N/AEnter door time
5.Thrombectomy centre called (LVO on CTA or VAN positive)(Suspected large-vessel occlusion)
≤ 15 min from CT report · Local target: call from the scanner
N/AEnter door time
6.Left for thrombectomy centre: door-in-door-out(Transferred for thrombectomy)
≤ 2 h from door · AHA/ASA systems-of-care goal: 120 min
N/AEnter door time
7.Disposition decided
Record · Admit / transfer / OT; for the length-of-stay audit
Enter door time
8.Patient left the ED
≤ 2 h from disposition decision · ED KPI: decision to departure 2 h or less
Enter door time

Bedside checklist

☐Straight to CT on the ambulance stretcher; bloods drawn on the way
☐Only glucose is needed before lysis; wait for INR only if anticoagulated
☐BP below 185/110 before lysis, below 180/105 for 24 h after
☐Tenecteplase 0.25 mg/kg single bolus (max 25 mg) or alteplase 0.9 mg/kg
☐Weigh on the trolley or estimate; write the dose at the scanner
☐Neuro and BP checks every 15 min for 2 h after lysis
☐Swallow screen before anything by mouth, including tablets
☐Bleed on CT: reverse anticoagulant, BP target, neurosurgery call

References

Targets marked “local” are suggestions: agree your own with the quality committee before auditing against them.

Bedside checklist

☐Straight to CT on the ambulance stretcher; bloods drawn on the way

☐Only glucose is needed before lysis; wait for INR only if anticoagulated

☐BP below 185/110 before lysis, below 180/105 for 24 h after

☐Tenecteplase 0.25 mg/kg single bolus (max 25 mg) or alteplase 0.9 mg/kg

☐Weigh on the trolley or estimate; write the dose at the scanner

☐Neuro and BP checks every 15 min for 2 h after lysis

☐Swallow screen before anything by mouth, including tablets

☐Bleed on CT: reverse anticoagulant, BP target, neurosurgery call