Emergency MedicineNeurology
Acute Stroke / TIA Assessment
Rapid assessment, diagnosis, and management of suspected acute ischaemic stroke and TIA using FAST, ROSIER, and NIHSS tools.
Source: NICE NG128; RCP Stroke Guidelines 2023
Used in: Stroke & TIA
Step 1 of ~12
action
Immediate Stroke Assessment — FAST
FAST screen:
F — Face drooping (asymmetric smile)
A — Arm weakness (drift or inability to raise)
S — Speech disturbance (slurred, inappropriate, absent)
T — Time to call 999 / activate stroke pathway
If FAST positive → direct to CT imaging. Target: door-to-CT scan ≤25 minutes.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
A deeper exam-focused version of this pathway is available on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only. Always apply local guidelines and clinical judgement.