Code White – Stroke Decision Assistant

Part 1 — Before Imaging

Time

Last Known Well (LKW)Current Time

Time Since Onset—

Left for Tenecteplase (4.5h)—

Left for Thrombectomy (9h)—

NIHSS

LOC

LOC Questions

LOC Commands

Best Gaze

Visual Fields

Facial Palsy

Motor Arm Left

Motor Arm Right

Motor Leg Left

Motor Leg Right

Limb Ataxia

Sensory

Language

Dysarthria

Extinction / Hemineglect

Total NIHSS

0/15 items scored

MINOR

LVO Screen

LVO Probability🟢 LOW

✅ Proceed with Non-Contrast CT Brain

Part 2 — Imaging & Decision

Imaging

CT Brain

MRI

FLAIR

DWI–FLAIR

SWI

MR Angiography

AI Interpretation

Acute Infarct❌ NO

Restricted Diffusion❌ NO

Established Infarct❌ NO

DWI–FLAIR Mismatch❌ NO

Hemorrhage❌ NO

Large Vessel Occlusion❌ NO

LVO Location—

Insufficient data — complete assessment and imaging.

Final Decision

🟢 TENECTEPLASE

NOT ELIGIBLE

✓≤ 4.5 hours from onset

✓No hemorrhage

✓DWI–FLAIR mismatch

✓No LVO

🔴 MECHANICAL THROMBECTOMY

NOT ELIGIBLE

✓LVO present

✓≤ 9 hours from onset

✓Imaging eligible (acute infarct, no hemorrhage)

Consultant Informed

Cath Lab Activated

🟠 DAPT

—

✓Low NIHSS

✓Established infarct

✓Out of window

✓No reperfusion candidate

Auto-Generated Output

NIHSS 0Onset —LVO Low

CODE WHITE – STROKE DECISION ASSISTANT
CONSULTANT HANDOVER (SBAR)

SITUATION
Acute stroke call. NIHSS 0 (Minor). No LVO identified.

BACKGROUND
Last Known Well: ____
Assessment Time: ____
Time Since Onset: ____
TNK Window Remaining (4.5h): ____
MT Window Remaining (9h): ____

ASSESSMENT
LVO Screen: No cortical signs — Probability: Low

Imaging:
CT Brain: Not done / pending
DWI: No acute restriction reported
ADC: Not confirmed
FLAIR: Pending
DWI–FLAIR: Pending
SWI: Pending
T1: Pending
T2: Pending
MR Angiography: Pending

RECOMMENDATION
Insufficient data — complete assessment and imaging.
Consultant informed: NO
Cath lab activated: NO

Clinical decision support only — does not replace clinical judgement or local stroke protocols.