Question: In regards to the new BLS 3.0.1 under the paramedic prompt card for acute stroke protocol contraindications, it clearly states CTAS 2 and/or uncorrected airway, breathing or circulatory problem. My question in regards to this contraindication is does this automatically make a patient a CTAS level 1 when they are presenting with all signs and symptoms of a stroke and meet stroke protocol or does this mean that any other issues (i.e. chest pain making them a CTAS 2) puts them out of stroke protocol?
The prompt card states CTAS 1 (not 2 as the question states) and/or uncorrected airway, breathing or circulatory problem.
The Prehospital CTAS Paramedic Guide ver 2.0 lists stroke less than 3.5 hours from onset in the CTAS Level 2 group. Given that the Prompt Card 3.0.1 now uses less than 4.5 hours from time of onset of stroke symptoms, the CTAS guide is out of date and will need to be changed in its next version.
If the patient has Chest pain with cardiac features - severe end-organ hypoperfusion - page 18 - (which would mean mottling and hypotension) then these features makes them CTAS Level 1 and they should be taken to the closest Emergency Department. Otherwise the patient should remain in the stroke protocol and be transported as CTAS Level 2 to the closest Stroke Centre.