Abstract
Acute stroke treatment has evolved greatly over the last 20years with a significant proportion of patients now receiving intervention where they would have previously been admitted for rehabilitation alone. The goal is to deliver intravenous thrombolysis safely and to proceed with endovascular retrieval in appropriate candidates. Simulation provides the opportunity to teach the criteria that are used to determine eligibility for thrombolysis and to predict whether a large-vessel occlusion may be amenable to clot retrieval. The objectives are to (1) score National Institutes of Health Stroke Scale, recognizing that the patient has a right hemispheric syndrome; (2) interpret a head computed tomography (CT) scan and CT angiogram of the head and neck, identifying a right internal carotid artery occlusion; (3) lower the patient's blood pressure cautiously to <185/110mmHg; (4) review the tissue-type plasminogen activator (tPA) eligibility with the patient and his spouse and recommend treatment; (5) direct administration of tPA using the correct dose and activate the endovascular team for endovascular clot retrieval.
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