A 45-year-old female presents with left-sided weakness and difficulty speaking. What is your next step?

In this scenario, the correct approach involves assessing the patient's blood glucose level. When a patient presents with acute neurological symptoms such as left-sided weakness and difficulty speaking, these could be indicative of a stroke, but they may also result from other conditions, including hypoglycemia.

Evaluating the blood glucose level is critical because a low blood sugar could mimic stroke symptoms. If hypoglycemia is confirmed and treated, it could significantly improve the patient's condition without the need for further interventions related to a stroke. Therefore, ensuring the patient's blood glucose level is within normal limits is a crucial and time-sensitive step before proceeding with any stroke protocol or treatment.

In this context, notifying the receiving hospital of a stroke alert is an important step but generally occurs after initial assessments and interventions are conducted, including blood glucose checks. Administering oxygen is relevant for patients exhibiting signs of respiratory distress or hypoxia but is not the immediate priority in the absence of those indicators. Thus, assessing blood glucose first allows for the most appropriate treatment based on the underlying cause of the symptoms.