Date Published

September 29, 2022

Updated For

ALS PCS Version ALS PCS Version 5.2


What is the rule for stroke bypass when symptoms resolve on scene? It doesnt specify for this scenario in the directive, and only says continue to bypass if symptoms resolve on transport. In this case our patients had stroke symptoms for 1-2 minutes that quickly resolved and he no longer had any symptoms. What is the most appropriate hospital in this scenario?


The contraindication in the stroke bypass is symptoms of the stroke resolved prior to paramedic arrival or assessment. In this rare scenario, the symptoms were present during the assessment, so this contraindication is not met. However, prior to initiating transport the symptoms improve/resolve. Medical council believes that this meets the spirit of the caveat contained within the Cerebrovascular Accident/Stroke Standard (Patients whose symptoms improve significantly or resolve during transport will continue to be transported to a designated stroke center) and as such, should be transported to the designated stroke centre.



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