A stroke occurs when blood flow to part of the brain is cut off, quickly damaging brain cells and requiring fast medical action. According to the CDC, over 795,000 people in the U.S. experience a stroke annually, with about 87% being ischemic strokes caused by blocked blood vessels, stopping oxygen from reaching the brain.
Healthcare professionals use the ACLS Suspected Stroke Algorithm as a systematic, step-by-step approach, to quickly identify and manage stroke symptoms. This includes recognizing early warning signs, calling emergency help, recording symptom onset time, performing a rapid stroke evaluation, monitoring vital functions like Airway, Breathing, and Circulation (ABCs), transporting the patient to the nearest hospital, conducting brain imaging, and initiating appropriate treatment. Early recognition and prompt action through this algorithm help protect the brain, preserve function, and give patients the best chance at recovery.
Note: This ACLS suspected stroke algorithm follows the guidelines of 2020-2025 (AHA)
There are two main kinds of stroke, and knowing the difference helps guide the right treatment. Each type affects the brain in a different way and needs quick medical care.
An ischemic stroke happens when a blood clot blocks the flow of blood to the brain. This can be caused by a clot that forms in a brain artery or one that travels from another part of the body. It often starts with plaque buildup in the arteries, known as atherosclerosis. There are two main types: thrombotic, when the clot forms in the brain, and embolic, when it comes from somewhere else. Doctors treat it with clot-busting medicine like tPA(tissue plasminogen activator), blood thinners, or by physically removing the clot. This type makes up about 87% of all strokes.
A hemorrhagic stroke happens when a blood vessel in the brain bursts and causes bleeding in or around the brain. This can happen because of high blood pressure, a weak spot in a blood vessel called an aneurysm, or a serious head injury. There are two main types: intracerebral, where the bleeding happens inside the brain, and subarachnoid, where it happens in the space around the brain. Treatment focuses on stopping the bleeding, lowering pressure in the brain, and fixing the damaged vessel if needed. Doctors may also give medicine to control blood pressure and prevent seizures. Hemorrhagic strokes are less common, making up about 13% of all strokes.
A stroke can happen quickly and needs fast action to get help. Using the BE FAST method makes it easier to spot the warning clues and know what to do right away.
1. Balance: Trouble in walking or feeling dizzy without a clear reason.
2. Eyes: Sudden blurry vision or trouble seeing in one or both eyes.
3. Face drooping: One side of the face may look uneven or droop when smiling.
4. Arm weakness: One arm feels weak or numb and may drift downward when raised.
5. Speech difficulty: Trouble in speaking, slurred words, or trouble understanding others.
6. Time to call EMS: If any of these happen, call emergency services immediately; every second counts!
The BE FAST method matters because it helps you quickly recognize the most common warning signs of a stroke. Time is critical; time is brain, so spotting these clues early means you can get medical help faster, which can save brain function and improve recovery.
Note: BE FAST was developed by Intermountain Healthcare as an adaptation of the FAST model implemented by the American Stroke Association. Reproduced with permission from Intermountain Healthcare. Copyright 2011, Intermountain Healthcare.
Knowing what to do when a stroke is suspected can make a big difference. This simple step-by-step approach helps healthcare teams act quickly and give the best care possible.
01.
The first step is to notice the signs and symptoms that might show a stroke is happening. Paying close attention to sudden changes like trouble speaking, weakness on one side, or vision problems can help you act fast and get help right away.
02.
Once you recognize the signs, the next step is to quickly alert the stroke response team. Getting the right experts involved right away helps make sure the person receives fast and focused care.
03.
After alerting the team, healthcare providers quickly check the person’s condition. This fast exam helps identify how serious the stroke might be and guides the next steps in treatment.
04.
Next, the medical team does a thorough neurological exam to understand how the stroke is affecting the brain and body. They often use the NIH Stroke Scale (NIHSS) to measure the severity of symptoms and help guide the best treatment plan.
05.
Right after the exam, doctors arrange for brain imaging, like a CT(computed tomography) scan or MRI(magnetic resonance imaging), as soon as possible. These images help them see what’s happening inside the brain and decide the best way to treat the stroke.
06.
Doctors will review blood tests and lab results to check for any issues that could affect treatment. Tests such as a complete blood count (CBC), blood sugar levels, and clotting studies are done to look for other possible reasons behind the symptoms and to see if specific treatments can be safely given.
07.
When an ischemic stroke is confirmed and the patient qualifies, doctors may use a medication like tPA as part of thrombolytic therapy. Approved by the FDA (Food and Drug Administration) in 1996, this treatment helps break up clots and restore blood flow to the part of the brain that’s affected.
08.
Keeping blood pressure within a safe range is very important during a stroke. The care team will carefully monitor and treat any changes to protect the brain and support recovery.
09.
After the patient is stable, more tests are done to find out what caused the stroke and how to prevent another one. This includes imaging of the blood vessels, like CT or MR angiography, along with checks on heart function and rhythm.
10.
Recovery continues after leaving the hospital. A team-based rehab approach, including physical, occupational, and speech therapy, helps the person regain everyday skills. Regular follow-up visits focus on managing risk factors, staying on track with medications, and offering emotional support.
When someone shows signs of a stroke, every minute matters. Getting to the hospital quickly helps doctors start the right treatment without delay.
Successful post-stroke care begins immediately when symptoms appear and extends throughout recovery and discharge. Prompt assessment and well-coordinated treatments are essential to prevent recurrence and support healing.
Rehabilitation after a stroke should start promptly to enhance recovery and avoid complications. A well-organized plan helps achieve the best functional results and facilitates a seamless transition from hospital to home care.
Well-organized discharge planning is crucial for a seamless transition from hospital to the next level of care. It helps lower the risk of readmission and promotes the best possible recovery for patients.
In summary, fast action and the right steps can make a huge difference when it comes to stroke care. The ACLS Suspected Stroke Algorithm gives healthcare teams a clear and proven way to quickly assess, treat, and support patients through every stage, from the moment symptoms appear to recovery and discharge. Knowing the signs, following each step, and acting without delay can help protect the brain and improve the chances of a better outcome. With strong teamwork and a focus on timely care, we can give stroke patients the best possible shot at healing and getting back to their lives.
It’s always better to be safe and call 911 right away. Don’t wait for symptoms to get worse; quick action can save a life.
Yes, strokes can happen to anyone, even children or young adults. While it’s less common, knowing the signs still matters at any age.
Some treatments, like clot-busting drugs, work best within a few hours of symptoms. If it’s too late, doctors focus on reducing damage and starting rehab.
No, it’s not safe to give them anything to eat or drink. A stroke can affect swallowing, and it could cause choking.
Be patient, encouraging, and involved in their rehab process. Helping with appointments, daily tasks, or just being there makes a big difference.
