Stroke protocol in ER

[Ggraf]

Hi, I'm finishing up my pre-Reqs to start a BSN program......so don't know much of anything yet.:)

When someone comes into the ER via ambulance with visible signs of a stroke, does the ER automatically administer tpa type medicine is a more thorough work-up done with imaging, etc. before they decide that?

Thanks for your opinion, Gina

[dianah, ASN]

Those hospitals designated as "stroke centers" will treat patients, in cahoots with the EMS systems, per a defined stroke algorithm.

https://www.acls.net/acls-suspected-stroke-algorithm.htm

If you do an online search you will find many hospitals' algorithms, based on the American Heart Association guidelines. :)

[Ggraf]

Thank you so much!

[AZQuik]

Yep pretty standard for stroke centers. Fingerstick, Cincinnati, ct w/o contrast, neuro consult, tpa, mri, if everything goes right. There is more but that's the gist.

BSN GCU 2014.

Sent from my iPhone using allnurses

[Lev, MSN, RN, NP]

If a patient with stroke symptoms comes in they go right back and if strongly suspicious, the stroke alert is activated which calls a whole bunch of people including CT to clear the table. The patient doesn't even go to a room. They are met by the physician in hall and we have little "stroke" kits to run their labs without scanning labels. The doctor does a preliminary mini neuro exam. If the doctor thinks it may be a stroke, they go straight back to CT to rule out a bleed. Then they come back to the room and we get an EKG, labs have come back by then, get extra IV lines, put them on the monitor, check their VS etc to prepare for TPA if indicated.

[turnforthenurse, MSN, NP]

CT takes priority in a patient coming in with stroke-like symptoms. We do not delay the CT for labs (especially that PT/PTT/INR, which is also very important, but again CT is even more of a priority), IV start, EKG or getting them hooked up to the monitor for VS.

[Lev, MSN, RN, NP]

CT takes priority in a patient coming in with stroke-like symptoms. We do not delay the CT for labs (especially that PT/PTT/INR, which is also very important, but again CT is even more of a priority), IV start, EKG or getting them hooked up to the monitor for VS.

We get the labs while the doctor is assessing the patient. We have a kit with a butterfly angiocath, not an IV to not delay treatment trying to get an IV. We are an AHA get with the guidelines gold plus stroke award facility. We have our own CT scanner which is not shared with the inpatient units so the trip to CT is short.

[turnforthenurse, MSN, NP]

Lab is part of our stroke team. They do a butterfly stick to get labs while the doc is examining the patient but we don't delay the CT for labs. Sometimes the pt goes straight to CT before the doc comes in but it just depends on what doc we have that day.