Evidence-based strategies in Stroke Management

Most of the time there’s nothing much to do for the ischemic stroke patient but here’s some evidence-based strategies that can potentially reduce morbidity/mortality:

  1. Positioning: Elevation of the head of the bed (HOB) > 30 degrees
  2. Glucose control: 7.7-10 mmol/L (hyperglycemia associated with increased ICP and progression to hemorrhagic conversion)
  3. Blood pressure control: 15% reduction MAP over 24 hours if BP exceeds 220/120 (likely best accomplished with nicardipine infusion to avoid overcorrection)
  4. Adjunctive therapies: Prevent fever and hypercapnia
  5. Early physio and occupational therapy
Emergency Medicine Kenya Foundation