Recognition of RN/MD of stroke

1. BART (Brain Attack Response Team) Recognition of RN/MD of stroke Are any of the following symptoms present? (FAST) Facial weakness: new Arm/leg weak/numb: new Speech: slurred or word-finding problems: new Think: you think it might be a stroke If yes to ‘FAST’, establish symptom onset time: when was patient last know to be ‘normal self’? If Symptom onset less than 12 hours, or if onset unclear Dial XXXX to initiate CODE BART Symptom onset greater than 12 hours ago • Notify attending MD 2) Notify stroke program RN via pager XXX.XXXX (24X7) for routine consult (next business day) • (DO NOT initiate BART) STROKE PROTOCOL EVAL: goal complete evaluation in less than 45 minutes 1) Assess ABC, rapid neuro assessment 2) Obtain Stroke Folder for MD to complete* 3) First BART responder re-establish focal neurologic symptoms and symptom onset time 4) Labs: if not done in last 24 hours, draw CBC, PT/PTT, BMP and send to lab for “STAT STROKE PROTOCOL PROCESSING” (secretary to alert lab X44225) 5) Place IV access 6) STAT Head CT (no contrast) - to be done in Emergency Department. Secretary to alert CT (X62959) to clear CT scanner for “stroke protocol patient” 7) RRT RN to facilitate direct ICU bed placement for patients requiring acute intervention or those with hemorrhagic strokes (intracerebral hemorrhage, subarachnoid hemorrhage) 8) Complete remaining exam upon return from CT 9) Obtain weight (if rt-PA candidate): place 2nd IV 10) STAT EKG 11) As indicated, Stroke RN to facilitate rt-PA administration after orders obtained from an MD with rt-PA privileges. Stroke Folders can be obtained from stroke units (3S/3SW, 7E, 10SW and Emergency Department) (To cancel Code BART call X3000)