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Emergency Stroke Protocol Overview

The document outlines the CODE STROKE algorithm for evaluating and treating patients presenting with symptoms of an acute stroke. It details the steps to take from patient arrival through evaluation, imaging, diagnosis, and initiation of treatment. The key steps are to direct the patient to immediate CT imaging, simultaneously notify the stroke team and begin evaluation within set time limits, and administer intravenous rtPA if eligible within 60 minutes of arrival to restore blood flow and minimize brain damage.

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Zharifah Fauziyyah Nafisah
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1K views1 page

Emergency Stroke Protocol Overview

The document outlines the CODE STROKE algorithm for evaluating and treating patients presenting with symptoms of an acute stroke. It details the steps to take from patient arrival through evaluation, imaging, diagnosis, and initiation of treatment. The key steps are to direct the patient to immediate CT imaging, simultaneously notify the stroke team and begin evaluation within set time limits, and administer intravenous rtPA if eligible within 60 minutes of arrival to restore blood flow and minimize brain damage.

Uploaded by

Zharifah Fauziyyah Nafisah
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Emergency Services CODE STROKE algorithm

Emergency Services CODE STROKE algorithm

Patient arrives to ED via EMS with pre- Patient presents to ED with Stroke
notification of Stroke, Blood Glucose > 50 Symptoms, Blood Glucose > 50

Documentation of Last Known


DIRECT TO CT Well (LKW) < 10 minutes
Positive for any:
 Facial droop/weakness
Simultaneously:
 Arm weakness/numbness
 MD evaluation
Door to MD < 15 minutes  Speech abnormality
 Notify UC Stroke Team
Brief neuro exam completed.  Time to act F.A.S.T.
 Order STAT Tests
(CT/CTA, CXR, EKG, CTA – Confirm LKW
interpreted within 2
hours of completion) Order
STAT Labs (CBC, Renal, LKW ≤ 12 hours
Coags, Troponin,
Pregnancy-if applicable)
**DO NOT DELAY CT**
YES NO

Activate CODE STROKE NO Code Stroke


Consult Neurology

Door to CT < 25 minutes Notify UC Stroke Team


R/o ICH < 15 minutes
Remember … TIME IS BRAIN!
Door to LKW < 10 minutes
513-844-7686
Door to MD < 15 minutes
 Patient Demographics Door to Notification of Stroke Team < 15 min
 POC Glucose Door to CT < 25 minutes
Door to CT Results
 LKW time Door to CT Result < 45 minutes
< 45 minutes
 What’s wrong? Door to Needle < 60 minutes

Hemorrhage No Hemorrhage
Acute Ischemic Stroke (AIS)

Consult Neurosurgery
981-2337 LKW ≤ 4.5 hours
Candidate for IV rtPA LKW > 4.5 hours – 12 hours
 STAT Labs (CBC, Renal, Coags,
or
Troponin, Pregnancy-if applicable)
Contraindication to rtPA
 STAT EKG
 2 IV Lines
Stroke team to determine
 BP < 185/110 course of treatment Prepare
 NIHSS upon return from CT to transfer for Endovascular
 Review rtPA eligibility criteria Treatment (if applicable)
Door to Needle < 60 minutes

Emergency Services CODE STROKE algorithm Patient arrives to ED via EMS with pre- notification of Stroke,

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