What is the most critical initial information to obtain in a patient suspected of having a stroke?

Obtaining information on when the patient was last seen normal is crucial in a suspected stroke case because this time frame significantly influences treatment decisions and interventions. Stroke treatments, such as thrombolysis and thrombectomy, are time-sensitive and effective only within a specific window. For instance, intravenous tissue plasminogen activator (tPA) is ideally administered within 3 to 4.5 hours of symptom onset. Knowing when the patient was last seen normal helps healthcare providers assess eligibility for these time-sensitive interventions, making it a critical piece of information in the acute management of stroke.

In contrast, while the initial blood pressure reading, the patient's activities at symptom onset, and the equality of pupils provide valuable information regarding the patient's overall condition and potential complications, they do not directly impact the immediate treatment timeline as the last known well time does. Thus, the timing of the onset of symptoms is the priority in acute stroke assessment.