Paramedic Initiated Lisinopril For Acute Stroke

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 60

Inclusion Criteria

1. Adults greater than or equal to 40 years old
2. New unilateral arm weakness thought to be due to acute stroke within 3 hours of symptom onset
3. Hypertension as defined by systolic blood pressure (SBP) greater than 160 mmHg on two consecutive seated or lying readings taken 5 - 10 minutes apart
4. Conscious (eyes open spontaneously i.e. 'A' on Alert, Voice, Pain, Unresponsive [AVPU] scale)
5. Patient being transported to a PIL-FAST trial site (i.e. Royal Victoria Infirmary, North Tyneside General Hospital and Wansbeck General Hospital)
6. Verbal consent obtained from participant or next of kin

Exclusion Criteria

1. Aged less than 40 years
2. Females who are pregnant, lactating or at risk of pregnancy (i.e. who are not surgically sterile or at least 1 year post last menstrual period). Females less than 56 years of age consented by a relative will be excluded as menstrual history may be unknown.
3. Any presentation of suspected stroke without unilateral arm weakness
4. Cannot establish that stroke onset time (i.e. when patient was last seen well without s symptoms) was within the last 3 hours
5. SBP less than 160 mmHg
6. Reduced level of consciousness (below 'A' on AVPU scale)
7. Patient not being transported to PIL-FAST trial site
8. Absence of participant or next of kin consent
9. Known to be taking ACE-inhibitor or Angiotensin II Receptor Blocker medication already
10. Known sensitivity to lisinopril or other ACE-inhibitor medication
11. Pulse greater than 120 beats per minute
12. Seizure activity in this illness episode (witnessed or history)
13. Hypoglycaemia (blood glucose less than 3.5 mmol/l)
14. Cannot walk independently prior to stroke (walking stick/frame is allowed)
15. Obvious understanding or memory problems when next of kin is absent
16. Significant head trauma or brain surgery in the last 3 months
17. Known renal failure
18. Known liver failure (or currently jaundiced)
19. Uncontrolled heart failure (breathlessness at rest)
20. Receiving palliative care for known malignancy
21. Currently enrolled in a clinical trial assessing a study drug

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method

Secondary Outcome Measures

Name	Time	Method

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