Decision making in suspected stroke

A Code Stroke may be called on a patient in the Emergency Department, or on the ward

Differentiating ischaemic stroke and haemorrhagic stroke is vital – and the likelihood of either affects the choice of initial imaging (MRI vs CT, respectively); VAD patients require a CT in either scenario.

Many patients require general anaesthesia to facilitate an MRI of sufficient quality to make the diagnosis. Where an MRI would entail a significant delay, the stroke team may consider awake CT as an alternative.

After imaging, a decision is taken for transfer to either:

• ED or the ward

• PICU

• Theatre for haemorrhagic stroke requiring neurosurgery

• Royal Melbourne Hospital for endovascular clot retrieval