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Table 1 Summary of guideline recommendations – diagnosis, specialist assessments and pharmacological management

From: Managing acute ischaemic stroke in a small island developing state: meeting the guidelines in Barbados

Recommendations Further information
Direct admission to specialised stroke unit
Diagnostic tests Neuroimaging (non-contrast CT/MRI)
Secondary diagnostic tests ECG and other cardiac investigations if indicated
Vascular imaging, e.g. CT/MR angiography and duplex ultrasonography
Specialists’ assessments Neurologist, nutritionist, physiotherapist, speech therapist, rehabilitation therapists
Pharmacological management
 Thrombolysis Intravenous alteplase within 3–4.5 h of symptoms for fibrinolysis
 Antiplatelet therapy Aspirin (acetyl salicylic acid) primarily (alternates: Clopidogrel or Dipyridamole)
Acute use (associated with slight reduction in mortality and morbidity)
Prescribed on discharge (secondary prophylaxis)
 Anticoagulants Avoid routine use except if at risk of thromboembolism
 Statins Avoid routine use
Advised for secondary prophylaxis