Scope & authority

This page covers alteplase/tPA continuation under PR-233, not field thrombolysis or another thrombolytic product.
The source’s stop criteria must remain visible during monitoring.

Adult / adolescent

Receive the sending team’s report: drug, dose, infusion rate, start time, destination, and transfer records. Record baseline consciousness, rhythm, heart rate, and BP.
Use a transport infusion pump at the rate prescribed by the sending RN/physician. PR-233 does not authorize selecting a new thrombolytic dose in the field.

No separate pediatric dose or field-initiation pathway is provided. Pediatric use must be governed by the treating team and transport authorization; do not extrapolate an adult stroke regimen.

Use the sending team’s patient-specific transport order and authorized scope. The cited transport procedure supplies no independent pediatric initiation regimen.

Weight	OCEMS pediatric dose
Any weight	No general pediatric dose under the cited source; follow the applicable order / medical direction.

Assess BP, heart rate/rhythm, and consciousness every 5 minutes. Protect the patient from injury during handling because hemorrhage is a major risk.
Immediately stop for new altered consciousness, a new headache, uncontrolled vomiting, systolic BP above 180, diastolic BP above 110, or a focal/generalized seizure.
Record findings and the stop time; proceed to the receiving facility and report the event immediately on arrival. New bradycardia prompts immediate reassessment of vitals and consciousness.