Acute Ischemic Stroke

A sudden focal neurologic change is a perfusion emergency until proven otherwise. In acute ischemic stroke, an arterial blockage deprives part of the brain of oxygenated blood, and threatened tissue can become infarcted as time passes. The PN's immediate contribution is not to independently label the stroke mechanism or select a reperfusion drug. It is to recognize the change, establish the last-known-well time, obtain and communicate focused findings, protect the patient from preventable harm, and report without delay. Brain imaging, blood pressure, symptom timing, and contraindications determine whether reperfusion is possible. Every minute spent on a routine task instead of the stroke pathway can reduce the opportunity to preserve neurologic function.