1. Rapid Identification and Diagnosis Confirm stroke diagnosis and perform initial physical evaluation within 10 minutes of patient arrival. Use standardized stroke screening tools (facial droop, arm drift, speech assessment). 2. Timely Imaging and Assessment Transfer suspected stroke patients to CT scan within 10 minutes. Interpret CT results promptly to determine eligibility for thrombolysis. 3. Eligibility and Safety for Thrombolysis Apply IV thrombolysis eligibility checklist (inclusion, exclusion, and relative contraindications). Obtain informed consent without delaying treatment. 4. Acute Stroke Management Initiate tPA or Tenecteplase therapy according to weight-based dosing protocols. Monitor vital signs and neurological status at specified intervals post-thrombolysis. Manage complications such as angioedema, bleeding, and allergic reactions. 5. Blood Pressure and Glucose Control Maintain BP within target ranges using recommended antihypertensive protocols. Keep blood glucose between 7.8–10 mmol/L during the first 24 hours. 6. Post-Thrombolysis and Ongoing Care Conduct NIHSS scoring and monitor for neurological deterioration. Implement dysphagia screening within 24 hours to prevent aspiration. Ensure positioning, skin care, and DVT prophylaxis. 7. Multidisciplinary Rehabilitation and Education Refer patients for physiotherapy, occupational therapy, speech therapy, and psychological support. Provide stroke education to patients and families, including risk factors and prevention strategies. 8. Discharge Planning and Secondary Prevention Prescribe appropriate antiplatelets/anticoagulants, statins, and antihypertensives. Arrange follow-up in neurology clinic within 2 weeks. Document functional outcomes (mRS and NIHSS) at admission and discharge.