Table 1

Acute ischaemic stroke: an ER protocol (routinely followed protocols across Pakistan)

Acute ischaemic stroke: an ER protocol
1.	Please carry out the following orders as appropriate	Yes	No	Date and time
2.	Plain CT head STAT
3.	CBC and platelet count
4.	prothrombin time (PT), INR
5.	Electrolytes, creatinine, glucose, Trop, liver function tests (LFTs)
6.	0.9% normal saline (NS) at 100 to 120 mL/hour for 24 hours. No dextrose saline (if congestive cardiac failure (CCF), use 0.9% NS at ≤60 to 70 mL/hour)
7.	If systolic BP>185 mm Hg or diastolic BP>110 mm Hg for ≥2 readings taken 5–10 min apart, use hypertension management protocol
8.	If random blood glucose >150 mg/dL, use S/C insulin protocol
9.	Metoclopramide 10 mg IV every 8 hours (for nausea/vomiting)
10.	Acetaminophen 1000 mg IV every 8 hours (for headache or fever >37.5°C)
11.	Aspirin 300 mg loading dose PO in ER if haemorrhagic stroke ruled out

BP, blood pressure; CBC, complete blood count; INR, international normalised ratio; IV, intravenous; PO, orally; S/C, subcutaneous; Trop, troponin.