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Which of the following does NOT indicate a contraindication for the stroke bypass protocol?

  1. PT is terminally ill

  2. Sustained chest pain

  3. CTAS 1

  4. Stroke symptoms resolved

The correct answer is: Sustained chest pain

In the context of the stroke bypass protocol, a contraindication refers to a condition or factor that serves as a reason to withhold a certain medical treatment or procedure. The choice of sustained chest pain does not inherently indicate a contraindication for activating the stroke bypass protocol. In situations where a patient is experiencing sustained chest pain, it is crucial to assess the nature and severity of the symptoms. While chest pain can indicate other serious medical conditions like a myocardial infarction, it does not preclude the assessment of stroke symptoms and does not interfere with the procedure related to stroke management. On the other hand, being terminally ill, having resolved stroke symptoms, or presenting with CTAS 1—indicating the highest level of urgency—are directly related to the appropriateness of a bypass for a suspected stroke. For instance, if a patient is terminally ill, it may alter the application of aggressive stroke interventions. Resolved symptoms may indicate that the stroke is no longer acute and thus may not warrant bypassing to a specialized stroke center. CTAS 1, while indicating critical need, can also present a complex clinical picture that requires careful evaluation in context. Thus, sustained chest pain is not an exclusion for stroke bypass, distinguishing it from the other