What Am I?
A bedside swallow screening done at bedside before a patient can receive anything by mouth, including medication, water or food.
Yale Swallow Protocol
Target time for CT Scan from symptoms discovery
Less than 25 minutes
Stretch goal of less than 15 minutes
Blood pressure target recommended after IV thrombolytic (Alteplase or Tenecteplase)
Acronym used for recognizing signs and symptoms of a stroke
B E F A S T
Criteria for calling a Code BAT in the inpatient units
Signs and symptoms of a stroke within 24 hours of last known well
Name 2 stroke core measures
Stroke Education; Antithrombotic by day 2; VTE prophylaxis; Anticoagulation at discharge if with Afib; PT/OT assessment; Statin
Leading cause of long-term disability
Stroke
Name some exclusion criteria for IV thrombolytics
Including but not limited to:
last known well >4.5 hours, ICH / SAH, stroke within last 3 months, B/P>185/110 despite treatment, nondisabling stroke, severe head trauma or intracranial/intraspinal surgery within 3 months, PLT <100 000/mm3, INR is >1.7 or PT is abnormally elevated, on therapeutic Lovenox dose or DOAC, aortic dissection, infective endocarditis.
Recommended monitoring frequency after IV thrombolytic administration
Vital signs and Neurological checks: every 15 minutes for 2 hours, every 30 minutes for 6 hours then 1 hour for 16 hours
NIHSS every 8 hours for 48 hours
IV thrombolytic used for treatment of acute ischemic stroke
Tenecteplase -first choice at Stony Brook
Alteplase - FDA-approved
This is called for patients who is suspected to have a large vessel occlusion
Code CSI
-both Neurology and Neurosurgery respond to the Code
-eliminates possible delay for thrombectomy
Name some risk factors for stroke
Including but not limited to:
High blood pressure; Cholesterol; Diabetes; Atrial Fibrillation; Carotid disease; Smoking; Hypercoagulable state
Area of brain at risk of progressing to infarction but is still salvageable if reperfused, located around an infarct core.
Ischemic penumbra
-The primary aim of current acute stroke intervention is to prevent the penumbra from proceeding to established infarct.
Target adminitration time for IV thrombolytic
Less than 60 minutes
Stretch goal of 45 less than minutes
Usual target blood pressure for hemorrhagic stroke patients
SBP < 140
or SBP < 160 if recommended by Primary Team depending on patient case