What is a StrokeThe word stroke refers to an acute neurologic impairment following interruption of blood supply to a specific area of tissue in the brain. Two major types of stroke are:
Stroke TreatmentStroke remains a leading cause of death in the United States. Early recognition and treatment of acute ischemic stroke is important, because IV fibrinolytic treatment should be provided as soon as possible. In stroke cases, an ECG should not take priority over obtaining a computed tomography (CT) scan. There is no arrhythmia specific for or related to stroke, but an ECG may help identify evidence of the cause of an embolic-type stroke. Many stroke patients demonstrate arrhythmias, but if the patient is hemodynamically stable, treatment of such arrhythmia is usually not indicated. Cardiac monitoring should be maintained during the first 24 hours of observation for patients who have experienced acute ischemic stroke so that atrial fibrillation and other potentially life-threatening arrhythmias may be detected. The goal of stroke care is to minimize brain injury and maximize the recovery. The American Heart Association (AHA) and American Stroke Association have developed a Stroke Chain of Survival. It correlates actions to be taken by patients, family members, and healthcare providers in order to maximize stroke recovery. The following are the established links:
Patients with acute ischemic stroke have a “time-dependent benefit” for fibrinolytic therapy. The critical time period for administration of IV fibrinolytic therapy begins with the onset of symptoms. Critical time periods from hospital arrival are as follows:
Adult Suspected Stroke AlgorithmRelated Articles
What needs to be completed for this patient within 20 minutes after hospital arrival?Obtain a 12-lead ECG and perform neurologic screening assessment. Do not delay CT, obtain CT without contrast within 20 minutes of patient arrival. A neurologic assessment by the stroke team or designee should be done within 20 minutes of patient arrival to the ED.
What time specific goal should occur within 10 minutes of a stroke patients arrival to the ED?The goal of the stroke team, emergency physician, or other experts should be to assess the individual with suspected stroke within 10 minutes of arrival in the emergency department (ED). The CT scan should be completed within 10-25 minutes of the individual's arrival in the ED and should be read within 45 minutes.
What test should the patient receive within 25 minutes of hospital arrival?The CT scan should be completed within 25 minutes from the patient's arrival in the ED and should be read within 45 minutes. Within 45 minutes of the patient's arrival, the specialist must decide, based on the CT scan or MRI, if a hemorrhage is present.
What stroke tool should be completed on arrival?Neurological Screening: The neurological screening should be performed within 10 minutes of arrival. The NIH stroke scale is a 15-item screening tool used to determine stroke and stroke severity.
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