lt 10 minutes Brief neuro exam Confirm Last Known Well Time LKW 1 Code Stroke Process 4 Notify UC Stroke Team lt 15 minutes 5138447686 Patient demographics POC Glucose ID: 1044139
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1. Code Stroke Process3. MD evaluation < 10 minutesBrief neuro exam Confirm Last Known Well Time (LKW)1
2. Code Stroke Process4. Notify UC Stroke Team < 15 minutes 513-844-7686Patient demographicsPOC GlucoseLKWWhat’s wrong? 2
3. Code Stroke Process5. Patient to CT scan < 25 minutes 6. CT Interpretation < 20 minutes (45 minutes from start of Code Stroke) Hemorrhage → consult Neurosurgery 513-981-2337 (981-BEDS) No Hemorrhage/Acute Ischemic Stroke (AIS) → evaluate if patient is a candidate for TPA3
4. Code Stroke TeamCODE STROKE Responders = Code Blue Team + ED Charge RN ED Charge RN to assist with baseline NIH ICU RN will respond to floor 2 and above CVU RN will respond to 1st floor and below ICU or CVU & Primary RN will accompany bedside nurse to CT (SBAR) PCU RN will document4
5. Code Stroke Team RolesPrimary RNCollects blood sugarObtains VSDetermines LKWSBAR to teamTransports to CT with ICU RN5
6. Code Stroke Team RolesUnit Charge RN Places patient on Zoll monitor Notifies attending/consulting MDs Notifies familyED Charge RNCompletes NIHSS*Ensures compliance with stroke algorithm & time frames6* PCU RN will document NIHSS assessment as ED RN does not have inpatient CarePath access
7. Code Stroke Team RolesICU/CVU RNTransports pt to CT with primary RNReports labs & CT result to hospitalistIf ordered, starts tPA (Alteplase) within 60 minutesIf hemorrhagic, Consults NeurosurgeryHospitalistEvaluates patient within 10 minutesReviews glucose resultProvides orders for labs, CTCalls UC Stroke Team within 15 minutesReviews inclusion/exclusion criteriaReports labs & CT result to UC Stroke Team7
8. Code Stroke Team RolesPCU RNDocuments events in CarePath using Code Stroke NarratorClinical AdministratorEnsures MD call to UC Stroke team within 15 minutesFacilitates patient transferPCABrings glucometer & WOW to roomBrings patient’s softchart and facesheet to roomRounds on other patients8
9. Code Stroke Team RolesRadiologistCalls CT result to primary RNPharmacistPrepares tPA (Alteplase) and delivers to ICU within 15 minutes of CarePath orderReviews dosage with ICU RN at bedside prior to administration9
10. Code Stroke - DocumentationMUST Document in a Code Stroke: Last known well (LKW) Blood Glucose Full set of vitals Full NIHSS – in EPIC flowsheet “What’s wrong?”...why did you call a Code Stroke??10