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Stroke (Suspected) — Utah 2025 Protocol

Last Known Well time is the most important thing you do. Time = brain.

Steps by Cert Level

ALL: Cincinnati Stroke Scale: Facial droop + Arm drift + Speech abnormality. ANY ONE positive = suspected stroke.
ALL: Get LAST KNOWN WELL (LKW) time immediately. tPA window: 3–4.5hrs from LKW. Thrombectomy window: up to 24hrs.
ALL: BGL check MANDATORY — hypoglycemia is the perfect stroke mimic. Transport to stroke center, NOT nearest ED. Pre-notify hospital.
PARAMEDIC: IV access en route. DO NOT treat hypertension unless SBP >220 — the brain needs perfusion pressure.