Show:
STROKE PROGRAM
ASSESSMENT
MEASURES
Odds & Ends
"CEREBRAL"
100
Staff receive stroke specific information from this.
What is your stroke coordinator, team leader, staff meetings, stroke team site, LMS Modules, or huddles?
100
Assessment used to quantify stroke symptoms and measure neurological function.
What is a NIHSS?
100
This is the time frame that your NIH needs to be documented within.
What is less than 15 minutes from arrival.
100
This person makes the decision to call a code stroke
Who is EMS, ER nurse, ER physician, or neurologist?
100
Acute stroke patients should have rapid evaluation by a non-contrast CT to help identify exclusion criteria for TPA such as this.
What is intracerebral hemorrhage?
200
SSM ensures standardized care of stroke patients by use of these.
What are stroke specific order sets and policy/procedures?
200
These are the required components of a neuro check.
What is LOC, cognition, speech, orientation, pupil/eye signs, motor all 4 extremities assessments, and sensation?
200
This must be documented before patient receives anything by mouth for anyone at risk of aspiration.
What is the nursing bedside swallow eval and 3 oz. water test?
200
We do this to avoid aspiration pneumonia in stroke patients.
What is dysphagia screen?
200
This is why we allow permissive hypertension immediately following an ischemic stroke.
What is maintain cerebral perfusion?
300
These are the stroke specific "target times" that are collected for ED.
What are door to doc (<15 min), door to NIH (<15 min), door to CT results (<45 min, door to lab (<45 min), door to EKG (<45 min), door to Alteplase (<60 min), door in door out (<60 if no tPA, <90 if received tPA).
300
A person you can call for questions or issues regarding stroke patients.
What is the stroke coordinator?
300
This medication should be given to patients within 45 minutes of arrival if they are a candidate.
What is Alteplase?
300
This is the upper level at which we treat blood pressure for ischemic stroke patients.
What is SBP >220 mmHg and/or DBP >120 mmHg? Fact: The blood pressure should only be lowered by 15% in the first 24 hours.
300
These are the three types of strokes.
What is Ischemic, ICH, SAH?
400
These are the organizations from whom we get our Clinical practice Guidelines (CPGs) that make up our order sets.
What is American Heart Association, American Stroke Association, The Brain Attach Coalition?
400
This should be documented at least hourly while in the ED on any patient here for neurological issues.
What are neurological checks and vital signs?
400
Stroke patients who are transferred out need to be discharged within this timeframe.
What is 90 minutes if receiving Alteplase and 60 minutes if not receiving Alteplase and transferring to a higher level of care?
400
This is the blood pressure that the patient needs to be below to receive Alteplase.
What is 185/110? After Alteplase is initiated then we need to stay under 180/105
400
Bleeding from this spreads over the surface of the brain resulting in a subarachnoid hemorrhage
What is ruptured cerebral aneurysm?
500
This is where you can find the stroke program Clinical practice guidelines
What is stroke program team sites on the intranet page?
500
Decrease level of consciousness, headache, seizure, pupil changes, Cushing's triad, vomiting, decreased motor strength or posturing are signs of this.
What are sign and symptoms of increase ICP?
500
This documentation is required on all suspected or rule out CVA/TIA workups.
What are hourly neuro checks, hourly vital signs, swallow eval, NIH, and last known well?
500
These are the required vital signs and neuro checks in patients that receive Alteplase.
What is q15 x 2 hours, q30 x 6 hours, and q1 hr x 16 hours? Repeat NIH post Alteplase in 2 hours
500
This is the part of the brain at risk of cell death in an acute stroke.
What is the penumbra? Best efforts should be made to saving penumbral areas, such as administration of Alteplase or endovascular treatment. As research has demonstrated that the amount of penumbral tissue saved and spontaneous neurologic recovery are closely related.