To optimize care for a stroke patient who is a candidate for thrombolytic drugs, what should an EMT do first?

Determining the exact time of onset of symptoms is crucial for optimizing care for a stroke patient who may be a candidate for thrombolytic therapy. Thrombolytic drugs, which dissolve blood clots, have strict time windows for administration to be effective and safe. Typically, these medications must be given within a specific timeframe from when the symptoms first began, often within three to four and a half hours, depending on the specific protocol and the type of stroke.

Knowing the onset time helps healthcare providers assess whether the patient is eligible for the treatment at the receiving facility and allows for prompt interventions. While a thorough physical exam and determining other vital signs are important, they come secondary to establishing the time of symptom onset. Selecting an appropriate hospital is also significant, but it should be done based on the onset timing and the facility's capabilities for stroke care.

Immediate transportation to a hospital is necessary but should not take precedence over the time assessment since timely administration of thrombolytics is critical for the patient's recovery and outcomes. The focus should always be on timing in acute stroke management to ensure the best possible care.