What should you assess first in a patient showing signs of an ischemic stroke?

In cases of suspected ischemic stroke, the priority is to quickly assess the symptoms and the time of onset. Understanding the symptoms helps identify the specific nature and severity of the stroke, which is crucial for determining the appropriate course of treatment. Identifying when the symptoms began is equally important because it guides the potential eligibility for interventions such as thrombolysis or thrombectomy. These treatments are time-sensitive and generally most effective when administered within a specific window after the onset of symptoms.

While parameters such as heart rate, rhythm, blood glucose levels, and the patient’s history of stroke are important assessments, they follow after the immediate evaluation of symptoms and time of onset. Heart rate and rhythm can indicate cardiac complications, and blood glucose levels are essential to rule out hypoglycemia, which can mimic stroke symptoms. The patient's history of stroke can inform treatment but is typically secondary to the more urgent need for understanding the current episode.