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MRI FAST head: sometimes performed in an acute setting, especially in wake-up strokes. Comparing different sequences can show if there is still perfusion and if someone would benefit from thrombolysis.

Administer a 500ml bolus of Hartmann’s solution or 0.9% sodium chloride (warmed if available) over less than 15 mins. Review the patient’s drug chart for medications which may cause neurological abnormalities (e.g. opioids, sedatives, anxiolytics). National Institutes of Health Stroke Scale (NIHSS)

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Keeping father time at bay: but why would we want to live to 180? Illustration: Nate Kitch/Observer Auscultation of the heart may reveal irregular heart sounds suggestive of atrial fibrillation. Investigations and procedures Intravenous cannulation The NIHSS is a systematic, quantitative assessment tool for stroke-related neurological deficits. The higher the number, the greater the deficit and the bigger the stroke.

Any medications or fluids will need to be prescribed at the time (in some cases you may be able to delegate this to another member of staff). Blood pressure lowering: aim for BP < 140 mmHg systolic (if <6 hours of onset) or < 180 mmHg systolic (if >6 hours of onset). Use labetalol 10mg IV, then consider GTN infusion. Request a CT head immediately in all cases of suspected stroke. A CT head is important to identify intracranial haemorrhage (as these patients must not receive thrombolysis).

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A LACS (lacunar stroke) is subcortical; therefore, higher cerebral functions (e.g. language) are preserved. Hence, these can be pure motor, sensory, sensorimotor, or cause ataxic hemiparesis alone. 3 Bamford stroke classification Haemorrhagic stroke Others claim they can already prevent aging in animals. George Church, a Harvard professor and the founder of Rejuvenate Bio, uses gene therapy to add anti-aging instructions to DNA. Church says he has succeeded in making mice live twice as long, and the secretive company is said to be planning imminent testing on dogs. All critically unwell patients should have continuous monitoring equipment attached for accurate observations. Repeat administration of fluid boluses up to four times (e.g. 2000ml or 1000ml in patients at increased risk of fluid overload), reassessing the patient each time. All hospitals admitting stroke patients should have a specialist stroke rehabilitation ward, or should have immediate access to one.

For patients who do not fit the criteria for acute management (thrombolysis/thrombectomy), general medical management involves: Inspect the size and symmetry of the patient’s pupils. Asymmetrical pupillary size may indicate intracerebral pathology. Until the end of time: James Strole, 70, founder of the Coalition for Radical Life Extension in Arizona, with some of the many pills and supplements he takes dailyRe-assess the patient using the ABCDE approach to identify any changes in their clinical condition and assess the effectiveness of your previous interventions. A nasopharyngeal airway is a soft plastic tube with a bevel at one end and a flange at the other. NPAs are typically better tolerated in patients who are partly or fully conscious compared to oropharyngeal airways. NPAs should not be used in patients who may have sustained a skull base fracture, due to the small but life-threatening risk of entering the cranial vault with the NPA.