Rapid and accurate assessment of patients with suspected stroke by emergency nursing personnel and paramedics is essential. Use of the FAST or the LAPSS scale by paramedics can identify the patient with acute stroke in the field, with moderate to excellent agreement with assessment by physicians. The early stages of patient stabilization and diagnosis are critical to brain function; thus, it is imperative to assess, monitor, and correct the ABCDs during emergency stroke management. These initial steps are not only crucial for maintaining brain function, but are invaluable for salvaging penumbral cells. Moreover, the prompt recognition of stroke will lead to quicker implementation of treatment and to effectively treating this disease as a high-priority emergency. Additionally, continued monitoring of the ABCDs can lead to early recognition of patient deterioration. Rapid intervention and preventing further brain deterioration are vital when emergency personnel evaluate stroke.