Stroke Recognition (all staff)
The phrase used to help remember recognizing the signs and symptoms of a possible stroke
BEFAST
A TIA is often called
The two diagnostic tests that must be performed and resulted prior to ordering thrombolytic therapy
Blood Glucose and CT Scan
Mat-Su Regional is certified as an Advanced Primary Stroke Center through which organization
The Joint Commission
This core measure is the inpatient nurse' responsibility
Stroke education specific to the patients condition and their risk factors
If someone has signs or symptoms of a stroke what do you do? (In the Hospital ____ ) (In the Community ___)
Call Rapid Response / Code *6999
Call 911
Name a risk factor that can be controlled ("modifiable risk factor") *50 bonus points if you name at least 3*
Hypertension, Smoking, Diabetes, Obesity, High Cholesterol, Atrial Fibrillation, Alcohol/Drug Abuse
Parameters for a Level One Stroke Alert are:
Stroke symptoms
LKWT <= 4 hours
or VAN + <= 24 hours
VTE prophylaxis must be documented as given (or on) before the end of hospital day 2 (true/false)
True
*note -if SCDs are ordered and never documented as on, this is a fall out
Before discharge, the patient should be assessed for these services
Rehabilitation Services
Describe what BEFAST stands for
B - Balance (dizziness, loss of balance)
E- Eyes (sudden change in vision / visual loss)
F- Facial Droop (ask them to smile)
A- Arms (loss of strength/coordination, unable to hold up)
S - Speech (slurred, word finding difficulty, unable to comprehend?)
T - Time to call 911
One year after quitting smoking, the risk of stroke reduces by
about half
The goal for 'door to needle' for thrombolytic therapy for acute ischemic stroke is ___. The goal for 'door in door out' for interventional stroke is ___.
45 minutes *Remember to call a LYTIC ALERT - goal lytic to ICU is 60 mins
90 mins * Remember Lifemed will standby on helipad prior to having an accepting facility
This medication needs to be given before the end of hospital day 2 in ischemic stroke patients
Anti-thrombotic medication (ex: Aspirin or Plavix, etc)
antithrombotic and statin
if appropriate: anticoagulant, diabetes medications, hypertension medications
Taking note of the time the person was last seen normal and when their symptoms were discovered is important why
These times determine eligibility for treatment therapies
The #1 risk factor for stroke is
Parameters for a Level Two Stroke Alert
LKWT between 4-24 hours and VAN negative
After a patient receives thrombolytics, frequent VS and NIHSS are performed when _____ and why
q15m x 2 hrs, q 30 m x 6 hrs, q 1 h x 16 hrs
-goals are to keep BP in parameters and monitor closely for any s/s neurological deterioration (bleed)
Without a clear cause of the patients ischemic stroke, it is typically called a cryptogenic stroke - name follow up monitoring that is often prescribed for this population
Long term cardiac monitoring to assess for A-Fib
Name 2 types of strokes
Ischemic or hemorrhagic
Name 2 examples of non-modifiable risk factors
Age, Gender, Family History, Personal History of Stroke/TIA
The maximum dose of Tenecteplase for acute ischemic stroke treatment.
The maximum BP before & after Lytic
25 mg (5 mL)
before 185/110
after 180/105
Call RRT - MD activates Stroke Alert
Stat CT/CTA/CTP - Telestroke consulted
Dispo pending imaging findings, symptoms severity, and treatment
In addition to risk factors and follow up appointments, it is important to consider the whole person - describe some additional considerations after stroke & what MSRMC offers
Depression, short term memory issues
Stroke Support Group - third tuesday evening monthly