How the recommendations might affect practice The recommendations reflect a small change to current best practice. The difference in target blood pressure range and magnitude in drop from starting treatment up to the first hour in the 2022 update might need additional planning and closer management by the nursing team. Given that these people currently need close monitoring, any change is likely to be very small. There may be an increased cost of intravenous antihypertension medication, but the recommendations should save resources because of reduced harms. Overall, the recommendations should not have a resource impact to the NHS in England. Return to recommendations Optimal positioning for people with acute stroke Why the committee made the recommendation The evidence did not indicate any difference in outcomes between lying flat or with the head elevated. No cost-effectiveness evidence was identified and no cost difference between the 2 strategies is expected. Therefore, the committee used their knowledge and experience to recommend positioning people according to their preferences and individual requirements. How the recommendation might affect practice Optimal positioning is an important part of early acute stroke management and rehabilitation. In current practice, people are assessed in bed and optimal head positioning 2022 is determined based on clinical presentation, medical needs and patient comfort. The recommendation therefore reflects current practice in most hospitals and so the committee agreed that there should be little or no change. Return to recommendation Early mobilisation for people with acute stroke Why the committee made the recommendations Regarding the recommendation to mobilise people after having a stroke when their clinical condition permits, there was no clear evidence of benefit or harm for early mobilisation within the first 48 hours after symptom onset compared with standard care. Therefore, the committee made a recommendation based on their knowledge and experience. 