“Some things you can do well or do quickly. Often in medicine you need to do both.” Just got out of the monthly meeting looking at our prehospital stroke code program. We are now three months into this pilot program designed to speed patients directly to CT from the field with lab work already drawn. The goal is to reduce Door to TPA time by shortening time to CT and lab results. We set an ambitious goal of deciding go\no-go in terms of TPA within 30 minutes of arrival. Using the Cincinnati Stroke Scale our paramedics identify potential stroke patients and expedite their care by inserting two peripheral IVs, obtaining needed blood specimen, and recording as much history of present illness that is available from the patient and relatives\bystanders. Upon arrival in ED these patients bypass an ED bed…