Inpatient Stroke Code by https://padlet.com/biancabrooks/98owrbgau6nu57lz en-us 2023-10-07 15:48:04 UTC 2024-02-07 12:18:49 UTC hello@padlet.com biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736558215 B = BALANCE Sudden trouble walking, dizziness, loss of balance or coordination.]]> 2023-10-07 15:51:15 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736558215 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736561076 E = EYESIGHT sudden trouble seeing in one or both eyes]]> 2023-10-07 15:56:02 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736561076 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736564165 F = FACIAL DROOP Sudden weakness or numbness of the face]]> 2023-10-07 16:01:43 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736564165 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736565984 A = ARM DRIFT Sudden weakness or numbness of the arm/or leg, especially on one side of the body ]]> 2023-10-07 16:03:54 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736565984 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736566905 S = SPEECH Sudden confusion, trouble speaking or understanding]]> 2023-10-07 16:04:50 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736566905 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736577980 T = TIME IS BRAIN! Call 33333 for Rapid Response/Code Stroke]]> 2023-10-07 16:24:11 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736577980 Code Stroke Criteria biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736586664 2023-10-07 16:39:19 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2736586664 STROKE STOP biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740242740
  • Check ABCS - Vital Signs
  • Determine LKW (Last Known Well)
  • POC Glucose
  • NIHSS or neuro check
  • Transport veteran to CT
  • Acquire pt weight
  • Administer O2 if Sats <94%
    • ]]>     2023-10-10 16:01:11 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740242740     To Initiate Code Stroke biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740332478
  • Call 33333
  • Use ED Code Stroke Pathway
  • Contact Telestroke at 1-877-676-3455, (469)-627-4790, or 224-240-7890
  • Contact CT and transport to CT stat!
    • ]]>     2023-10-10 16:55:58 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740332478     biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740333613 2023-10-10 16:56:43 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740333613 Telestroke Worksheet biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740334706 2023-10-10 16:57:26 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740334706 Inpatient Stroke Protocol biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740405309 2023-10-10 17:42:37 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740405309 Acute Stroke Timeline biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740523476 2023-10-10 19:02:20 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740523476 Brief Focused History biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740526581
  • Taking anticoagulant? If so, what? When was the last dose?
  • Recent surgery or procedure?
  • Recent severe bleeding?
  • History of any brain bleed?
  • Any other pertinent history?
    • ]]>     2023-10-10 19:04:50 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740526581     Know the BP Goal! biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740531467
  • Appropriate BP management is essential for patient survival.
  • ALWAYS clarify BP goals with provider and KEEP BP within GOAL!
  • Check BP after every BP med and q15 while titrating drip.
  • Never drop BP by more than 25% in 1st hour.
    • ]]>     2023-10-10 19:08:27 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740531467     Ischemic Stroke BP Goals biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740534400 Intervention anticipated:
    • <185/110 to give thrombolytic
    • <180/105 post thrombolytic
    • <220/120 if no intervention

    _______________________________________________
    Avoid hypotension! Generally do not drop <140-160 SBP
    ]]>     2023-10-10 19:10:43 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740534400     Hemorrhage (ICH, SAH) BP Goals biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740542140
  • Ask provider for goal
  • Goal range generally 140-160 SBP
    • ]]>     2023-10-10 19:16:46 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740542140     biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740545706 2023-10-10 19:19:43 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740545706 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740549988 2023-10-10 19:23:10 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740549988 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740550710 2023-10-10 19:23:50 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740550710 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740551638 2023-10-10 19:24:37 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740551638 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740552408 2023-10-10 19:25:24 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740552408 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740555571 2023-10-10 19:28:15 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740555571 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740556006 2023-10-10 19:28:39 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740556006 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740561367 2023-10-10 19:33:26 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740561367 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740561915 2023-10-10 19:33:54 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740561915 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740562231 2023-10-10 19:34:12 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740562231 Thrombolytic should be given after CT of head biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740564290
  • Manage BP
  • Weigh Pt (If not already done)
  • Calculate dose with 2nd nurse and neurologist
  • Provider to retrieve consent
    • ]]>     2023-10-10 19:35:59 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740564290     Alteplase Indication biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740574415
  • Clinical diagnosis of ischemic stroke with potentially disabling neurologic deficit
  • LKW established as <4.5 hours (270 minutes) before treatment can begin
    • ]]>     2023-10-10 19:45:13 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740574415     TPA Exclusions biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740579828 2023-10-10 19:49:59 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740579828 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740581249 2023-10-10 19:51:18 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740581249 Dosage Calculation biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740587657 2023-10-10 19:57:18 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740587657 Alteplase reconstitution and administration biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740593627 2023-10-10 20:00:04 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740593627 Stroke Kit biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740594302 2023-10-10 20:00:42 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740594302 Monitoring biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740596188 2023-10-10 20:02:14 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740596188 Stroke Activation biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740601332 2023-10-10 20:06:49 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740601332 Dysphagia Screen biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740601741 2023-10-10 20:07:10 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740601741 NIHSS biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740602999 2023-10-10 20:08:27 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740602999 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740613428 2023-10-10 20:18:22 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740613428 biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740616757 2023-10-10 20:21:47 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2740616757 CT W/O Contrast Order Entry biancabrooks https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2876496474 2024-02-07 12:18:49 UTC https://padlet.com/biancabrooks/98owrbgau6nu57lz/wish/2876496474