Stroke Ready

The app is now named Stroke Ready, and this release applies a source-checked clinical content audit of its dosing, window and monitoring content. Changes affect thrombolytic dosing, treatment-window labeling, anti-platelet eligibility and subarachnoid hemorrhage blood pressure. THROMBOLYTIC DOSING Tenecteplase now shows both dosing methods together: 0.25 mg/kg up to a maximum of 25 mg, per the 2026 AHA/ASA guideline and the pivotal trials, and the TNKase FDA label section 2 table, which assigns a fixed dose by weight band rather than by calculation. The label bands are shown in full: under 60 kg 15 mg (3 mL); 60 to under 70 kg 17.5 mg (3.5 mL); 70 to under 80 kg 20 mg (4 mL); 80 to under 90 kg 22.5 mg (4.5 mL); 90 kg and above 25 mg (5 mL). The app notes that the bands round up, so for most weights the labeled dose is higher than the mg/kg calculation (40 kg: 10 mg by calculation, 15 mg by label; 65 kg: 16.25 mg by calculation, 17.5 mg by label), and directs you to confirm which method your facility order set uses before drawing up. Both the Medications entry and the thrombolysis pathway carry this dual presentation. Alteplase remains 0.9 mg/kg to a maximum of 90 mg, with a 10 percent bolus over 1 minute and the remainder over 60 minutes. TREATMENT WINDOWS AND LABELING The thrombolysis pathway now carries a labeling caveat: both FDA labels indicate treatment within 3 hours of symptom onset. Activase: "Administer as soon as possible but within 3 hours after onset of symptoms." TNKase: "Initiate treatment as soon as possible and within 3 hours after the onset of stroke symptoms." Both thrombolytic entries state that treatment in the 3 to 4.5 hour window, and in the imaging-selected extended and wake-up windows, is guideline-endorsed but off-label for both agents. The guideline-based 4.5 hour window from last known well remains the app's core indication for eligible patients with a disabling deficit. ANTIPLATELET THERAPY Dual anti-platelet therapy eligibility now reads: minor non-cardioembolic stroke with NIHSS at or below 5, or high-risk TIA, started within 24 hours, per the 2026 AHA/ASA acute ischemic stroke guideline. Regimen is unchanged: clopidogrel 300 to 600 mg load then 75 mg daily with aspirin for 21 days, followed by single anti-platelet therapy. SUBARACHNOID HEMORRHAGE BLOOD PRESSURE The aneurysmal SAH monitoring card now states the 2023 AHA/ASA recommendation directly: control blood pressure with short-acting agents and avoid hypotension, hypertension and blood pressure variability before the aneurysm is secured. No numeric pre-securing target is given, because the 2023 guideline states that available evidence is insufficient to recommend any specific BP target. The card notes that SBP under 160 mmHg is a widely used institutional target and directs you to your own facility protocol. The Monitoring and Interventions screens now use consistent wording for pre-securing blood pressure. SOURCES Guideline citations re-verified as the current editions: 2026 AHA/ASA acute ischemic stroke, 2022 AHA/ASA intracerebral hemorrhage, 2023 AHA/ASA aneurysmal subarachnoid hemorrhage. New FDA label content is attributed inline to the TNKase and Activase prescribing information. Stroke Ready remains an educational reference, not a substitute for clinical judgment or facility protocol. Verify every dose independently before administration.