158: What’s Changed in Acute Stroke Care? New AHA Stroke Guidelines with Dr. Prabahkaran

158: What’s Changed in Acute Stroke Care? New AHA Stroke Guidelines with Dr. Prabahkaran

From Rapid Response RN by Sarah Lorenzini

March 13, 2026 · 32 min

About this episode

Dr. Shyam Prabhakaran discusses the recent changes in acute stroke care and the new AHA Stroke Guidelines.

The stroke guidelines just changed and it’s exciting and nuanced! What you do in the first 30 minutes could drastically change your patient's outcome. In this episode, Dr. Shyam Prabhakaran, neurologist and chief writer of the new 2026 AHA Stroke Guidelines, explains what's changed and how these guidelines are changing practice at the bedside. Stroke treatment decisions are getting faster, more nuanced, and more imaging-driven. Inclusion/exclusion criteria and whether to give thrombolytics, who is a candidate for thrombectomy, and when to touch the blood pressure have all been updated. Know the updates before your next stroke alert! Topics discussed in this episode: Introducing the classic extended window patient case Thrombolytics vs. thrombectomy explained EMS destination decision: Choosing primary vs. comprehensive stroke center How reperfusion time windows have changed Advanced imaging: ASPECTS and thrombectomy eligibility Treatment options for patients presenting outside of the 4.5 hr window Blood pressure management recommendations What nurses should do in the first 15-30 minutes LVO red flags at the bedside Pediatric ischemic stroke Check out the new AHA Stroke Guidelines…

People in this episode

Host: Sarah Lorenzini

Guest: Dr. Shyam Prabhakaran

Topics covered

  • acute stroke care
  • AHA Stroke Guidelines
  • thrombolytics
  • thrombectomy
  • blood pressure management
  • advanced imaging
  • pediatric ischemic stroke

Keywords

  • stroke guidelines
  • patient outcome
  • treatment options
  • reperfusion time
  • LVO red flags
  • EMS destination decision
  • blood pressure management

Mentioned in this episode

Organizations: AHA, CONNECT

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