Hemisphere IV-Rapid Stroke Response Exam Questions With Verified Answers

Hemisphere IV-Rapid Stroke Response Exam Questions With Verified Answers .EMS goal on scene 15 minutes .Oxygen saturation in stroke 94% .Onset of symptoms to thrombolytics time 4.5 hours .Onset of symptoms to thrombectomy time 24 hours .Stroke Center designations Comprehensive Stroke Center (CSC) Thrombectomy-capable stroke center (TSC) Primary Stroke Center (PSC) Acute Stroke Ready Hospital (ASRH) .Door to door transfer time = 60 min hospital to hospital transfer .associated symptoms of stroke *especially with cerebellar and hemorrhagic stroke vomiting, nausea SBP 220 stiff neck Photophobia Coma and decreased level of consciousness .Overlooked symptoms of stroke dizziness headache general weakness or fatigue nausea, vomiting disorientation, confusion, or memory problems .Door to doctor time ASAP - 10 min .BP parameters do not treat elevated BP unless concurrent myocardial infarction, heart failure, aortic dissection, or confirmed hemorrhagic stroke .Door to stroke team time (neuro expertise) ASAP - 15 .Prior to thrombolytic Noncontract CT or MRI to exclude hemorrhage Blood glucose level - to rule out hypoglycemia BP under 180/105 .When to repeat CT in Hosp to hosp transfers 60 minutes since last CT ,Baseline labs CBC, electrolytes, Renal function creatinine, troponin and ecg to evaluate MI and arrhythmias Coag studies if on anticoagulants Advanced imaging if considering mechanical thrombectomy .Airway management Swallow screen should be performed on all stroke patients npo until complete .How long is BP elevated after stroke 24-48 hrs .Increased cardiac risk with stroke Arrhythmias (including A-fib) observed in about 25% of patients within 72 hrs of stroke Cardiac troponin may elevate from autonomic dysfunction in acute MI/heart failure .Blood glucose and stroke Persistent hyperglycemia 24 hours following stroke is associated with worse outcomes Hypoglycemia can mimic stroke symptoms Maintain glucose 60 and 180 .When to raise bed 30 degrees Risk for Aspiration Cardiopulmonary issues Increased intracranial pressure .Temperature and strokes Fever increases metabolic demand, which may increase risk of brain injury .Stroke mimics Hypoglycemia TIA Seizure Migraine Toxic Metabolic Cause Sepsis Syncope Mass Lesion Conversion Disorder .AEIOU tips Causes of mental status A alcohol acidosis E epilepsy, encephalopathy I insulin O overdose U uremia T tumor trauma I infection