Hypertension and Stroke



  • Age >16; may or may not have altered level of consciousness
  • Assess ABCs and suspicion for trauma
  • Assess patient with Cincinnati Stroke Scale
    • Facial droop (big smile)
    • Pronator drift (extend arms, palms up, eyes closed: one arm drift = positive; both = unclear)
    • Speech (“The sky is blue in Cincinnati”)
  • Assess and record the exact time the patient was last known to be normal
  • Glucose level should be >70mg/dL
  • Rapid transport and pre-notify destination Emergency Department
  • Minimize scene time to <10 mins; do not delay unnecessarily for procedures; attempt IVs and other procedures during transport
  • Refer to ED capability chart for transport destination selection
  • Consider transport to a JCC Primary or Comprehensive Stroke Center if:
    • Stroke center is <15 mins farther than a non-stroke center
    • Last known normal <12 hours



  • Treat patient per appropriate protocol
  • Assess patient for stroke symptoms; assess BP in opposite arm of initial reading
  • If positive for stroke symptoms, GO TO STROKE – M414