Emergency Department and PICU Clinical Pathway
for Stroke Management
High Concern
Low Concern
- Further care, Neurology consult as clinically indicated
Persistent
Neurologic Symptoms/Deficits
Neurologic Symptoms/Deficits
Resolution of
Neurologic Symptoms/Deficits
Neurologic Symptoms/Deficits
- Obtain imaging per discussion with Stroke Team with CT or MRI
- Imaging per ED/Neurology Discussion
- Continue neuroprotective intervention
- Discuss further care with Stroke Team
- Antithrombosis
- Anticonvulsants
- Special cases
- Initial Treatment Guidelines
- Normal CT or MRI
- Reassess symptoms
- Discuss disposition with Stroke Team
Admit ICU
Admit to Neurology/ICU or
discharge to home
discharge to home
Stroke Screening Questions
- Is there a focal neurologic deficit?
- Unilateral weakness or sensory change
- Vision loss, double vision
- Speech difficulty
- Dizziness or trouble walking
- New onset seizures with focal findings
- Did the problem begin or get worse suddenly?
- What was the time of symptom onset?
- When was child last seen symptom free?
- When did the child last eat or drink?
- Does the child have dental hardware?
Evidence
CHOP Program
Educational Media
Related Links