Stroke Hosp
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2 Critical Assessments and Actions 4 Immediate Assessment by Stroke Team 5 Does CT Scan Reveal Hemorrhage? 6 Possible ischemic stroke No Yes certification institute www.aclscertification.com Adult Suspected Stroke © ACLS Certification Institute www.aclscertification.com | 1-800-448-2078 Fast, Convenient and 100% Online ACLS Training and Certification Earn Your ACLS in 1-2 Hours. Certify or Recertify Today! ACLS Immediate Patient Assessment and Stabilization 3 1 Patient presents with signs and symptoms of possible stroke/CVA Initiate emergency response/EMS system Assess and support ABC’s, supply oxygen if needed Initiate pre-hospital stroke assessment Establish last normal (time of symptom onset) Alert and transport patient to appropriate stroke center Obtain blood glucose reading Assess ABC’s, vital signs Initiate appropriate oxygen therapy if hypoxic Establish vascular access, send blood for appropriate lab testing Assess for and treat hypoglycemia Perform stroke screening assessment Activate stroke team Order stat CT scan or MRI of brain Perform 12-Lead ECG Obtain/review patient history Establish last normal (time of symptom onset) Perform NIH Stroke Scale or Canadian Neurological Scale exam Consider fibrinolytic therapy Perform fibrinolytic exclusions screening Repeat neuro exam (are symptoms improving to normal?) 7 Consult neurosurgeon or neurologist Immediate transfer to appropriate facility if neuroservices unavailable 8 Patient candidate for fibrinolytic therapy? No Administer Aspirin Review risk/benefits of fibrinolytic therapy with patient/family If acceptable, give rtPA Withhold anticoagulants or antiplatelet treatment for 24 hrs Yes 9 Admit to neuro unit or appropriate ICU If neurological condition worsens, order stat repeat CT scan 11 10 12 Initiate post-rtPA stroke pathway Continuous monitoring of BP per protocol and for any neurological changes/deterioration Emergent admission to stroke/neuro unit or appropriate ICU NINDS Time Goals (From ED Arrival) 10 min 25 min 45 min 45 min 60 min 60 min 3 hrs NINDS Time Goal (From Stroke Admission) 10 min 25 min 3 hrs
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Transcript of Stroke Hosp
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2 Critical Assessments and Actions
4 Immediate Assessmentby Stroke Team
5 Does CT ScanReveal
Hemorrhage?
6 Possible ischemic stroke
No Yes
certication institutewww.aclscertication.com
Adult Suspected Stroke
ACLS Certification Institutewww.aclscertification.com | 1-800-448-2078
Fast, Convenient and 100% Online ACLS Training and CertificationEarn Your ACLS in 1-2 Hours. Certify or Recertify Today!
ACLS
Immediate Patient Assessmentand Stabilization
3
1 Patient presents with signs and symptoms of possible stroke/CVAInitiate emergency response/EMS system
Assess and support ABCs, supply oxygen if neededInitiate pre-hospital stroke assessmentEstablish last normal (time of symptom onset)Alert and transport patient to appropriate stroke centerObtain blood glucose reading
Assess ABCs, vital signsInitiate appropriate oxygen therapy if hypoxicEstablish vascular access, send blood for appropriate lab testingAssess for and treat hypoglycemiaPerform stroke screening assessmentActivate stroke teamOrder stat CT scan or MRI of brainPerform 12-Lead ECG
Obtain/review patient historyEstablish last normal (time of symptom onset)Perform NIH Stroke Scale or Canadian Neurological Scale exam
Consider fibrinolytic therapyPerform fibrinolytic exclusions screeningRepeat neuro exam (are symptoms improving to normal?)
7 Consult neurosurgeon or neurologistImmediate transfer to appropriatefacility if neuroservices unavailable
8 Patient candidatefor
fibrinolytic therapy?No
Administer Aspirin
Review risk/benefits of fibrinolytic therapy with patient/familyIf acceptable, give rtPAWithhold anticoagulants or antiplatelet treatment for 24 hrs
Yes 9Admit to neuro unit or appropriate ICUIf neurological condition worsens, order stat repeat CT scan
11
10
12 Initiate post-rtPA stroke pathwayContinuous monitoring of BP per protocol and for any neurological changes/deteriorationEmergent admission to stroke/neuro unit or appropriate ICU
NINDS Time Goals(From ED Arrival)
10 min
25 min
45 min45 min
60 min
60 min
3 hrs
NINDS Time Goal(From Stroke Admission)
10 min
25 min
3 hrs
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