A summary of the Canadian Stroke Best Practice Recommendations, Sixth Edition (2018): Updates relevant to prehospital and emergency medicine providers.

The 2018 update of the Heart and Stroke Foundation of Canada’s Canadian Stroke Best Practice Recommendations for Acute Stroke Management, Sixth Edition (CSBPR, 6th Ed.) was developed with input from the Canadian Association of Emergency Physicians (CAEP) Stroke Practice Committee and approved by the CAEP Executive Board. It provides comprehensive, evidenceinformed recommendations for the management of acute ischemic stroke (AIS) and transient ischemic attack (TIA). This article aims to highlight recommendations from the CSBPR, 6th Ed. that are particularly relevant to stroke care in the prehospital and emergency department (ED) settings, including several significant changes for endovascular thrombectomy (EVT) extended treatment time windows and revisions for the triage and management of TIA based on recent evidence. This article is a condensed synthesis of the CSBPR, 6th Ed. reflecting solely the opinions of the authors through a review outside of CSBPR methodology. Readers are encouraged to refer to the primary CSBPR documents, freely available online at www.strokebest practices.ca, for full details of the peer-reviewed recommendations. If specific language from the CSBPR, 6th Ed. is conveyed, it is indicated by quotation marks with the source recommendation location identified by a section number (e.g., Section 3.3.ii). Otherwise, unquoted text represents the commentary of the authors alone in summarizing the CSBPR, 6th Ed. recommendations. All tables taken or modified from the CSBPR, 6th Ed. and presented here are shared with permission from the Heart and Stroke Foundation of Canada, SAGE, and the International Journal of Stroke. (Tables 1 and 3) Recommendations from the CSBPR, 6th Ed. are organized into the following major sections: