Needs to be documented prior to any PO including medications
What is a bed side swallow screen
100
The team you call when you have an acute change of condition for any inpatient.
What is a MERT
100
F-Face
A-Arms
S-Speech
T-Time
What is identification of stroke symptoms (F-A-S-T)
100
LDL result 100 or greater or patient on a cholestrol reducer prior to admission
What pt is required to be discharged on a statin medication or LIP documentation why not precscribed.
200
1.A Positive St Rose Stroke Scale
2. Last known well / Onset time within last 8 hrs
or
acute onset unresponsiveness of unclear etiology
What is our Code White activation critera
200
physician documents that patient has none or minor deficits and opts not to refer the patient for further therapy.
What is rehablitation plan considered
200
PT count <100,000, PTT > 40 sec, PT > 15, INR > 1.7, serum glucose < 50 or >400, SBP > 180 or DBP > 110, seisure at onset of stroke and acute MI or pericarditis
What is relative contraindications for tPA
200
Personal risk factors for stroke
Warning signs of a stroke
Activation of EMS/ call 911
Follow up discharge instructions
DC medications instructions
What medications prescribed at hosptial discharge (unless contraindicated )
300
Door to doctor- 5 minutes or less
Door to CT- 10 mins (RDL 15 mins)
Door to CT interpretation- 25 mins
Door to all results - 45 mins
Door to tPA - 60 mins
What are the stroke timeline targets
300
vital signs and neurological check q 15 mins for 2 hrs
vital signs and neurological check q 30 mins for 6 hrs
vital signs and neuorlogical check q 1 hr for 16 hrs
What is post tPA vital sign and neurological check requirements
300
age greater than 80
NIHSS score > 25
hx or previous stroke and diabetes
all patients recieving an oral anticoagulant
What is exclusion criteria for tPA between the 3-4.5 hr time frame?
What medications a patient needs to be discharged on if they have a history of or has a diagnosis of Afib/Aflutter.
400
A system that is designed to allow medical experts to be in 2 places at once. This capability allows a physician to consult on a patient remotely and make immediate life-saving decisions
What is telemedicine
400
All patients who have strokes are at a higher risk for developing deep vein thrombosis (DVT). Immobility and paralysis increase risk for DVT’s and potential PE in both ischemic and hemorrhagic stroke patients
What is the stroke core measure is to have VTE addressed by the end of day 2
400
IV tPA- 3-4.5 hrs
IA tPA- 6hrs
IA Mechanical Thrombectomy- 8hrs
What are time sensitive treatment opportunities for acute strokes?
400
acute impairment of cerebral blood flow resulting in a variety of neurological deficits. Sudden blockage of oxygen and nutrients to brain causing death to brain cells
What is the definition of an acute ischemic stroke
400
antithrombotics
What all ischemic strokes need to be discharged on unless contraindicated then the reason needs to be documented by the LIP at discharge
500
CBC, platelets, PT/INR, PTT, glucose and electrolytes
What labratory tests that need to be resulted prior to the administration of tPA.
500
LIP using the stroke order sets on admission
What is the best way to prevent stroke measure fall outs
500
Penumbra neurons may remain viable for up to 6-8 hours
What is the time frame to save the ischemic penumbra
500
headache, nausea/vomiting, vertigo, imbalance, ataxic, diplopia, decreased LOC