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Signs and Symptoms
Time is Brain!
Assessment
Treatment
Prevention
100

The acronym BEFAST which helps people remember the signs of stroke stands for

What is balance, eyes, face, arm, speech, time?

100

Our goal is 15 minutes

What is our door to CT Goal?

100
This imaging test is the most sensitive study in detecting acute ischemia.
What is MRI Brain with diffusion weighted imaging?
100

Goal of 5 Minutes or less

What is our order of Thrombolytic to administration goal?

100
Name 2 ways to prevent stroke by optimizing risk factors.
What are treat hypertension, control DM, HLD, ASA within 48 hours, warfarin/NOAC if have Afib, diet and exercise?
200

Diplopia (double vision), Dizziness or vertigo, Dysarthria (slurred speech), Dysphagia (difficulty swallowing), and Dystaxia (impaired coordination and balance)

Signs of a posterior stroke

200
Timely hospital admission is important to prevent these post-stroke complications
What are pneumonia, UTI, bed sores, DVT/PE, other infections?
200
Focused history questions to ask concerning recent events
What are recent events like stroke, MI, trauma, surgery, bleeding? or "Last known well"
200

If patient eligible for thrombolytic, blood pressure should be consistently less than...

What is 185/110?

200
3 ways that stroke clinic is helpful for patients after a stroke
What are prevention of new CV event, education for patient and family, and treatment of chronic complications after stroke.
300
Name 3 risk factors for stroke
What are tobacco use, DM, alcohol overuse, HTN, HLD, medication compliance with anticoagulants, family history, prior history of stroke?
300
Door to needle time should be less than...
What is 60 minutes?
300
Specific medication question to ask early in triaging patients with concern for stroke.
What is asking specifically about anticoagulants?
300
24 hours is the treatment window for this intervention
What is endovascular thrombectomy?
300
Etiology work up to prevent future strokes may include these diagnostic tests
What are vascular imaging, Echo, MRI brain, angiogram, genetic testing?
400
When all three of these signs of stroke are present, the sensitivity for stroke is approximately 90%
What are face droop, arm weakness, and slurred speech?
400
Less than 3 hours is the minimum treatment window for this type of treatment. More recent studies have shown benefit within 4.5 hrs.
What is acute thrombolysis with tPA?
400
Well validated stroke severity score used to assess for stroke, guide treatment, and determine prognosis. It is a requirement for stroke center certification.
What is the NIH stroke scale?
400
Blood pressure up to this value is permitted in hopes of improving cerebral perfusion to the area of ischemia in patients ineligible for tPA. (i.e. permissive HTN)
What is 220/120?
400
Name at least 3 treatable atherosclerotic stroke risk factors
What are HTN, DM, smoking, HDL? Others might include Afib, carotid artery stenosis.
500

Sudden onset of THIS symptom is associated with high suspicion of hemorrhage

What are sudden, severe headaches (worse HA of their life) especially with nausea/vomiting and/or obtundation?

500
Per stroke, estimated number of neurons lost = 1.2 billion, with 8.3 trillion synapses lost, and this number of years is the estimated number of years of accelerated aging after a stroke.
What is 36 years?
500
"Great mimicker" of stroke that is usually checked with a finger stick
What is hypoglycemia?
500
Three main medication options for antithrombotic therapy for secondary prevention of CVA are...
What are ASA, Plavix, and Aggrenox (ASA/dipyrimidole)?
500
For stroke recovery, this early intervention is recommended for improvement of deficits and prevention of long term disability.
What is Early mobilization?