Stroke (CVA)
See Ischemic-Stroke - Acute YKHC Clinical Guideline and Inpatient/Common Adult Admissions/Cerebrovascular Accident (CVA) (do we have guidelines for suspected stroke in the village? These would be really helpful because this comes up a lot)
Consider an urgent medevac if a patient with acute stroke symptoms presents to a village clinic where there might be enough time from onset of symptoms to completion of a Head CT in the ER in Bethel to be within the 4.5 (or 3) hour limit to consider thrombolytics following evaluation with risk assessment. Otherwise commercial transport with an escort to the ER might be a more appropriate option in an otherwise stable patient with neurologic deficiency consistent with an acute or subacute process. While awaiting transport in the village clinic, supplemental O2 and IV fluids may be appropriate but not aspirin until a hemorrhagic process in the brain can be ruled out in the ER.
