2026 Guideline Update: Early Management of Ischemic Stroke

New guidance on timing of thrombolytics and thrombectomy

For the intensivist, management of acute ischemic stroke is fairly straightforward:

1. Call a code stroke.

2. Make sure the ABCs are managed and vital signs are reasonable.

3. Stand around wearing a serious expression, watching other people do serious things.

Of course, there’s a bit more to it than that. And even if you aren’t performing thrombectomies yourself, it’s good to know what’s happening, what should be happening, and why.

Fortunately, the American Heart Association’s 2026 guideline update has arrived to help keep you up to speed. PulmCCM is not affiliated with the American Heart Association.

If you’re short on time to read the 119-page document, here’s a human-composed take on the most relevant points for the practicing intensivist.