Acute stroke assessment (adult UK pathway)
A source-linked educational visual of adult acute stroke recognition, urgent imaging, reperfusion decisions and stroke-unit care from NICE NG128.
Important safety note
This visual algorithm is an educational representation of published UK clinical guidance and is not a substitute for clinical judgement, local protocols, senior/specialist advice, or the original guideline. Verify current guidance before clinical use.
Scope and source
- Scope
- Adults with suspected acute stroke in UK emergency and acute-care services.
- Jurisdiction
- UK
- Primary guidance
- NICE NG128: Stroke and transient ischaemic attack in over 16s
- Guidance last updated
- 2022-11-23
- Clinical reference reviewed
- 2026-09-08
- Review due
- 2027-03-08
Interactive clinical algorithm
This source-backed visual algorithm is available in the interactive page experience. Open the original guidance and the node notes before clinical use.
How to read this visual
- Read across the columns for the phases of the pathway; the swimlanes are who acts — Emergency team, Imaging and radiology, Stroke and neurosurgical specialists.
- Bold marks the dose, threshold or time limit that decides the next step; the rest of a label is context.
- Record last-known-well time and activate the stroke pathway while performing ABCDE assessment.
- Open node notes for imaging, reperfusion timing and antiplatelet sequencing.
Clinical notes
- Thrombolysis and thrombectomy eligibility require organised stroke-service assessment.
- Use local transfer, anticoagulant-reversal, blood-pressure and posterior-circulation protocols.
Sources
- NICE NG128: Stroke and transient ischaemic attack in over 16s (NICE; 2022-11-23)
Open an editable reference copy
Create a personal educational copy. Verify the original guidance before clinical use.