The draft clinical policy related to the management of adult patients presenting to the emergency department with acute ischemic stroke is in the review stage of ACEP clinical policy development. Comments on the draft are being sought by the ACEP Clinical Policies Committee. Please focus your comments on the clinical content of the document, and not copyediting. Document your comments in the format requested, making note of additional evidence as appropriate. All comments will be carefully reviewed by the Committee and used to further refine and enhance the draft when evidence supports the changes. Individual reviewer names will not be used in the final document. Comments do not imply endorsement of the document and will be stated as such in the final document.