فاطم شوقي شوقي حذافه 55yrs old female pt unknown medical illness Presented to ER

Assessment: The presentation of sudden right-sided numbness, paresthesia, and weakness suggests a possible acute stroke or transient ischaemic attack (TIA) and requires urgent evaluation. Use a validated tool such as FAST to screen for stroke symptoms and exclude hypoglycaemia as a cause. Immediate neurological assessment is essential given the focal neurological deficits and symptom onset at 6:00 pm ²,³,⁵.

Measure oxygen saturation and note the hypoxia (SpO2 84% without oxygen). Supplemental oxygen should be administered to maintain SpO2 between 94% and 98%, unless there is risk of hypercapnic respiratory failure ¹,²,⁵.

Management: Arrange immediate emergency hospital admission to a hyperacute stroke unit for urgent specialist assessment and brain imaging to exclude intracranial haemorrhage and confirm diagnosis ²,⁵. Pre-alert the receiving stroke team with details of symptom onset, current condition, and medications including aspirin use ²,⁵.

Do not delay transfer for aspirin administration if already given; continue aspirin if previously administered unless contraindicated ²,⁷. Do not start anticoagulation until haemorrhage is excluded by imaging ²,⁵. Monitor airway, breathing, and circulation while awaiting transfer, and provide oxygen to correct hypoxia ²,⁵.

Exclude other causes of neurological symptoms if stroke is ruled out, and consider further neurological referral if symptoms persist or evolve ³.