Assess that stroke patient
What is the assessment utilized for our Intracranial Thrombectomy patients pre/during/post procedure
NIHSS
What are IR time goals for door to first pass for a patient coming from an outside hospital.
60 minutes!
Where does about 90% of the population house their language center in the brain.
Left side or Right Side
Left Side
What medication is given in IR for Vasospasm
IA verapamil
What is the time goal for calling the ED RN when coming in on call?
5 Minutes from arrival
True or False: You can test Visual Fields on your Comatose Patient
TRUE: you can utilize blink to threat!
What are IR time goals for a patient coming through the ED for door to 1st pass
90 minutes!
What are the major signs of stroke.. Hint BEFAST
B- Balance
E-eyes
F- Face
A- Arm
S- Speech
T-Time
What treatments can be done in IR for hemorrhagic stroke ICH or SAH?
Coiling and/or stenting
Intracranial Thrombectomy has been completed for your stroke patient. You are now taking them up to the ICU. They did not recieve TNK prior to arrival. What handoff sheet do you need to bring to the ICU with you
Yellow sheet, restarted from time of Hemostasis
The patient received TNK at an outside hospital 1 hour ago, was transferred to UCH straight to IR for thrombectomy. What frequency of NIHSS assesments need to be done or documented as UTA?
Q15 min
How do you handle multiple stroke patients at one time, when on call
If neuro team is in a stroke, then the body team will need to be called in for the second stroke. For MD, there is a backup Neuro IR Md on call, and will have to be called.
The patient arrives to IR has:
Severe expressive aphasia
Right arm weakness
Visual Field Cut
Where do you think this patients occlusion is?
Left MCA
The patient comes in with severe sudden headache, neck pain, and sensitivity to light. This is their CT, what type of hemorrhage do they have?
Subarachnoid Hemorrhage
Call a stroke Alert 8-5555
Testing for Neglect, this patient has it.
What is goal Blood pressure for a patient S/P TNK.
180/105
The patients symptoms are:
Left arm weakness, Right Gaze deviation, Neglecting Left side of body, slurred speech.
Right MCA
What is one of the biggest causes of ICH (intracerebral Hemorrohage)
High Blood Pressure
When do you need to pass of an orange sheet to the receiving unit?
When the patient has had a neuro intervention, or Diagnostic Angio.
Post thrombectomy, what is the frequency of NIHSS, groin checks, pulses, Vital Signs needed.
Q15 x 2 hours, Q30x 6 hours, then Q1 x 16hours
What is a potential complication post TNK administration, and how is it treated
Orolingual Angioedema, Treat with Benadryl 50mg, methylprednisolone (solu-medrol) 125mg
What areas of the brain does the Basilar Artery perfuse.
Brain Stem, cerebellum, and part of the occipital lobes
What is a vasospasm
Occurs when blood irritates the arteries, causing them to clamp down. The spasm then decreases blood flow to areas of the brain
When does the NIHSS need to be performed for a patient coming for thrombectomy from an outside hospital, and recieved TNK.