Code Stroke Process

3. MD evaluation < 10 minutes

• Brief neuro exam
• Confirm Last Known Well Time (LKW)

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 Code Stroke Process
4. Notify UC Stroke Team < 15 minutes
513-844-7686
• Patient demographics
• POC Glucose
• LKW
• What’s wrong?

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 Code Stroke Process
5. 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 TPA

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 Code Stroke Team
CODE 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 document

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 Code Stroke Team Roles
Primary RN
o Collects blood sugar
o Obtains VS
o Determines LKW
o SBAR to team
o Transports to CT with ICU RN

5
 Code Stroke Team Roles
Unit Charge RN
o Places patient on Zoll monitor
o Notifies attending/consulting MDs
o Notifies family
ED Charge RN
o Completes NIHSS*
o Ensures compliance with stroke algorithm & time
frames

* PCU RN will document NIHSS assessment as ED RN

does not have inpatient CarePath access
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 Code Stroke Team Roles
ICU/CVU RN
o Transports pt to CT with primary RN
o Reports labs & CT result to hospitalist
o If ordered, starts tPA (Alteplase) within 60 minutes
o If hemorrhagic, Consults Neurosurgery
Hospitalist
o Evaluates patient within 10 minutes
o Reviews glucose result
o Provides orders for labs, CT
o Calls UC Stroke Team within 15 minutes
o Reviews inclusion/exclusion criteria
o Reports labs & CT result to UC Stroke Team

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 Code Stroke Team Roles
PCU RN
o Documents events in CarePath using Code Stroke Narrator
Clinical Administrator
o Ensures MD call to UC Stroke team within 15 minutes
o Facilitates patient transfer
PCA
o Brings glucometer & WOW to room
o Brings patient’s softchart and facesheet to room
o Rounds on other patients

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 Code Stroke Team Roles
Radiologist
o Calls CT result to primary RN

Pharmacist
o Prepares tPA (Alteplase) and delivers to ICU
within 15 minutes of CarePath order
o Reviews dosage with ICU RN at bedside prior to
administration

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 Code Stroke - Documentation
MUST 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??

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