I B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Baseline troponin assessment is recommended in patients presenting with AIS but should not delay initiation of IV alteplase or mechanical thrombectomy. I C-LD Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Usefulness of chest radiographs in the hyperacute stroke setting in the absence of evidence of acute pulmonary, cardiac, or pulmonary vascular disease is unclear. If obtained, they should not unnecessarily delay administration of IV alteplase. IIb B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Additional support for this reworded recommendation from the 2013 AIS Guidelines comes from a cohort study of 615 patients, 243 of whom had chest x-ray done before IV alteplase. Cardiopulmonary adverse events in the first 24 hours of admission, endotracheal intubation in the first 7 hours, and in-hospital mortality were not different between the 2 groups. Patients with chest x-ray done before treatment had longer mean DTN times than those who did not (75.8 minutes versus 58.3 minutes; P=0.0001).111 See Table XXVI in online Data Supplement 1. 3. General Supportive Care and Emergency Treatment 3.1. Airway, Breathing, and Oxygenation 3.1. Airway, Breathing, and Oxygenation COR LOE New, Revised, or Unchanged Airway support and ventilatory assistance are recommended for the treatment of patients with acute stroke who have decreased consciousness or who have bulbar dysfunction that causes compromise of the airway. 