Page 1 of 17
HEMISPHERE IV-RAPID STROKE RESPONSE
EXAM ALL QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
Hemisphere IV-Rapid Stroke response
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
1
, Page 2 of 17
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
2
, Page 3 of 17
Cardiopulmonary issues
Increased intracranial pressure
Temperature and strokes
Fever increases metabolic demand, which may increase risk of brain injury
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)
3
HEMISPHERE IV-RAPID STROKE RESPONSE
EXAM ALL QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
Hemisphere IV-Rapid Stroke response
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
1
, Page 2 of 17
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
2
, Page 3 of 17
Cardiopulmonary issues
Increased intracranial pressure
Temperature and strokes
Fever increases metabolic demand, which may increase risk of brain injury
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)
3
