Document:

1. Date/time of last known well

2. Date/time of symptom onset

3. Date/time of initial assessment

4. Date/time of CT read

5. Initial NIHSS

6. tPA and thrombectomy decision

   • Reason for not administering tPA, if applicable

   • Reason for delay if goal time not met, if applicable

   • Post-intervention NIHSS, if applicable

HD 2 begins at first midnight (e.g. HD 1 starts on arrival, HD 2 starts at midnight, regardless of arrival time)

• By the end of HD2

  1. Document NIHSS

  2. Initiate pharmacologic VTE prophylaxis or document contraindication

  3. Initiate antithrombotic (e.g. ASA) or document contraindication

1. Assess for post-acute rehab (consult PT/OT/SLP) or document contraindication (e.g. returned to baseline, patient/family refused, transitioned to comfort care, etc.)

2. Depression/cognitive screen

1. Document NIHSS and mRS

2. Prescribe antithrombotic (ASA 81 vs DAPT vs anticoagulant) or document contraindication

3. Prescribe statin or document contraindication