Calling codes

From the description it does not sound like a "code" situation, but rather a urgent response situation. There is a 4 hour window of opportunity for stroke symptoms to be treated with the clot busting drugs. Yes, time is of the essence, but if the patient is not experiencing cardiac or respiratory distress or absence thereof no code situation exists at that moment.

well it seems like OP has a code stroke which is essentially a rapid response for a stroke patient.

Kind of like code yellow which at my hospital is a combative person.

I read it as the equivalent of a rapid response: neuro

Calling a code is not the same as Rapid response. I would have done an RR.

Escalating it in any way was the RIGHT thing to do, however.

it depends on the set up of the hospital response systems. Where I work we have a "code stroke" as well - it is local / hospital terminology.

My hospital has code blue = dead (full arrest). Code Rapid Response = pretty much everything else including seizure, found down, syncopal episode (including visitors), respiratory distress, hypotension, or ANYTHING the nurse feels is appropriately worried about. If the patient is outside the hospital and is brought in by ambulance for stroke symptoms, it's a Code Stroke. However, if the patient is inpatient, we call a Rapid Response to get the code team doctor to evaluate patient and then activate the stroke team. Same idea, just a different process that bypasses the overhead paging.

I'm transitioning to a medical oncology floor after 10 months in a SNF, and i'm not going to lie, calling a code is something i wonder about when i move to acute care. in the SNF i didn't have any issues making the decision to call 911 but we also had to get a Physicians order first. your post just helped me decide to call a code if i see fit. thank you

Our docs don't show up to RR. So code stroke is like a RR for neuro- and we get the doc, the IV team and the CT table clear which doesn't all happen for RR. Thanks all so much.

Time is brain, call the code.

You say ct was negative, was last seen normal within 4 hours of symptom onset? If yes, why was TPA not administered? The contraindication window's pretty small these days, mostly concerning anti-coag therapy.

Bottom line for me, you did the right thing.

You did the right thing by calling.

In many places, FAMILY MEMBERS are allowed to call for a RR if they are concerned. You are the patient's RN - if you feel the need to make the call go ahead and make the call. As someone else said, you'd rather be called 99 times and not be needed then not be called the one time you were.

Yup did the right thing. Get the wheels in motion even if you don't need it down the road. Time is brain!

You were absolutely correct in calling that stroke code. Situations like that are exactly why we have stroke codes! Good job, Nurse!

From the description it does not sound like a "code" situation, but rather a urgent response situation. There is a 4 hour window of opportunity for stroke symptoms to be treated with the clot busting drugs. Yes, time is of the essence, but if the patient is not experiencing cardiac or respiratory distress or absence thereof no code situation exists at that moment.

It's a specific protocol for new-onset stroke sx, distinct from a code blue for cardiac/respiratory arrest

for tPA the criteria becomes more strict as time goes on...typically from what i understand tPA can be administered up to 4.5 hours but is less effective compared to if it was administered within 3 hours of the patients "last known well"