For a patient with RACE score 1-4 and BgL 60-400, which action should you perform first?

For a patient with RACE score 1-4 and BgL 60-400, which action should you perform first?

• A. Tele to receiving facility
• B. Vascular Access
• C. Cardiac Monitor/12 Lead
• D. Administer tPA

Answer: (A)

In acute stroke care, getting the hospital involved early is the most impactful move because it speeds evaluation, imaging, and treatment if thrombolysis is appropriate. A RACE score in the 1–4 range suggests stroke symptoms are present but not strongly predictive of a large vessel occlusion, so the priority is to trigger the hospital’s stroke protocol rather than waiting for additional testing. The glucose value of 60–400 mg/dL means there isn’t an immediate glucose-related barrier to thrombolysis, so you can proceed with the stroke pathway rather than delaying for glucose correction. Therefore, the best first action is to contact the receiving facility to activate the stroke alert and pre-notify the ED and stroke team, so they can prepare for rapid imaging and possible thrombolysis. Other tasks, such as establishing vascular access or cardiac monitoring, should be done in parallel but do not supersede the need to notify the hospital first.

In acute stroke care, getting the hospital involved early is the most impactful move because it speeds evaluation, imaging, and treatment if thrombolysis is appropriate. A RACE score in the 1–4 range suggests stroke symptoms are present but not strongly predictive of a large vessel occlusion, so the priority is to trigger the hospital’s stroke protocol rather than waiting for additional testing. The glucose value of 60–400 mg/dL means there isn’t an immediate glucose-related barrier to thrombolysis, so you can proceed with the stroke pathway rather than delaying for glucose correction. Therefore, the best first action is to contact the receiving facility to activate the stroke alert and pre-notify the ED and stroke team, so they can prepare for rapid imaging and possible thrombolysis. Other tasks, such as establishing vascular access or cardiac monitoring, should be done in parallel but do not supersede the need to notify the hospital first.