The Code Stroke Handbook
Approach to the Acute Stroke Patient

A 65-year-old patient arrives at the Emergency Department with stroke symptoms that began 45 minutes ago. You are called STAT!Acute stroke management has changed dramatically in recent years. Tremendous advances have been made in acute treatments, diagnostic neuroimaging, and organized systems of care, and are enabling better outcomes for patients. Stroke has evolved from a largely untreatable condition in the acute phase to a true medical emergency that is potentially treatable?and sometimes curable. The Code Stroke emergency response refers to a coordinated team-based approach to stroke patient care that requires rapid and accurate assessment, diagnosis, and treatment in an effort to save the brain and minimize permanent damage.The Code Stroke Handbook contains the "essentials" of acute stroke to help clinicians provide best practice patient care. Designed to assist frontline physicians, nurses, paramedics, and medical learners at different levels of training, this book highlights clinical pearls and pitfalls, guideline recommendations, and other high-yield information not readily available in standard textbooks. It is filled with practical tips to prepare you for the next stroke emergency and reduce the anxiety you may feel when the Code Stroke pager rings.

Dr. Micieli completed his undergraduate degree and Business Master’s degree at the University of Toronto. He completed his medical school training at the University of Ottawa, and is currently a senior adult neurology resident at the University of Toronto. His research focuses on decision analytic models to evaluate the cost-effectiveness of health technologies, specifically in atrial fibrillation and intracranial hemorrhage. He is an aspiring stroke neurologist, and will be completing his stroke fellowship at the prestigious Calgary Stroke Program.
Dr. Joundi received his MD from Queen’s University and DPhil from Oxford University on a Rhodes Scholarship. He was co-chief neurology resident at the University of Toronto and is pursuing a stroke fellowship at the University of Calgary.
Dr. Khosravani is appointed as a Clinician in Quality & Innovation and Assistant Professor of Medicine, in the Division of Neurology, Department of Medicine, University of Toronto. His interests are quality improvement at different levels of care relevant to hyper-acute stroke management and inpatient stroke services. At the level of hyperacute stroke care, his focus is on improvement of door-to-needle times for thrombolysis. He is also working on understanding and improving factors that are relevant to a successful thrombectomy program in a comprehensive stroke center. He is medical director of the inpatient stroke unit, and interested in development of stroke pathways, the overlap between internal medicine and inpatient stroke neurology, and development of a framework for excellence in comprehensive neurovascular care. Dr. Khosravani is a member of Thrombosis Canada and interested in the implementation of stroke-best practices in the area of antithrombotics and anticoagulation. Dr. Khosravani also has a strong interest in utilizing computation and computer science to facilitate safe and high quality acute stroke care.
Dr. Hopyan is a stroke neurologist and Co-Director of the