When you or someone else experiences a stroke, seconds genuinely count. Knowing when to call the emergency services and what will happen when they arrive is of utmost importance to help ensure that the person affected receives quality medical care as soon as possible.
Calling for help through an official Stroke Alert can make all the distinction – but what exactly does this alert involve?
In this post, we’ll break down every step of its procedure, so you can be prepared whenever you need assistance due to a stroke-related situation.
Table of Contents
What is Stroke Alert?
A stroke alert protocol is an emergency notification system hospitals use to identify stroke patients quickly. When someone experiences a stroke, every moment counts. That’s why hospitals have developed systems that allow them to respond rapidly and provide potentially lifesaving treatment.
A stroke alert usually includes a team of healthcare providers, such as neurologists, radiologists, and emergency department staff, who work together to evaluate and treat patients suspected of having a stroke. By activating a stroke alert, hospitals can help assure patients receive the proper care they need as quickly as possible, improving their chances of full recovery.
When is the time to call for a stroke alert?
A stroke is an emergency, so you will call using the code “Stroke” to initiate the stroke alert. Every hospital has different procedure in such situation. Once you call, a rapid nurse or doctor will assess the patient and determine if there is any possibility of stroke.
Because if your quick response to this situation, you can save the patient from significant damage like the neurological deficit. So, as soon as you see any signs and symptoms of stroke, you must follow the hospital procedure and call for a stroke alert.
Act F.A.S.T. to Identify Stroke
To identify stroke quickly, you can use the F.A.S.T. acronym:
F-Facial – Ask the person to smile – does one side of their face droop down?
A-Arms – Ask them to raise both arms – does one arm drift downward?
S-Speech – You can also ask the person to repeat an easy phrase – is their speech slurred or strange?
T-Time – If you find any of these symptoms, it’s time to call for help [911].
Why is the need to act quickly in such situation?
There exist multiple methods of treating stroke. These methods require a rapid response when you hear stroke code, as most ischemic strokes can be treated with tPA, which is only effective within 4.5 hours of the stroke onset.
Additionally, some devices can extend this window by delivering medicine directly to the clot and ways to remove blood clots mechanically, but time is of the essence. Even a minor stroke – a transient ischemic attack – needs immediate medical attention.
What happens after you call the stroke alert?
While stroke protocols vary from hospital to hospital, you can anticipate the following things to occur rapidly.
- A doctor or a rapid response nurse will evaluate patients for stroke severity. Some facilities use the N.I.H.S.S. scoring system to assess the severity of symptoms.
- Patients will be taken to the imaging suite for a STAT non-contrast head C.T. scan (also called a “dry head”). Depending on the initial evaluation, the doctor may order additional scans such as a C.T. angiogram or perfusion scan. The goal is to get the patient from the stroke alert to the C.T. scan as quickly as possible, often within 10 minutes.
- Ensuring that the patient has IV access is also a priority. It’s not uncommon for two IV lines to be placed to administer medications and fluids quickly if needed.
- The medical team will draw labs, such as coagulation studies, C.B.C., a chemistry panel, and blood glucose.
These are the general steps that occur when you call a stroke alert. It’s important to remember that your acting quickly can save someone’s life – so don’t hesitate to contact us for help if you suspect someone is having a stroke. When in doubt, dial 911.
Now, the further procedure depends upon a C.T. Scan result:
Option A: If the C.T. scan is negative for a bleed:
- The patient will need thrombolytic medication such as alteplase (Activase), which may be used to break up the clot and restore blood flow to the brain tissue.
- The use of alteplase relies on several factors, including the time since last seen normal (L.S.N.), the patient’s medical history, blood pressure, presence of active bleeding, and lab results (including blood glucose level).
- For a long time, alteplase was only used for patients with an L.S.N. of three hours or less. Alteplase is now used for up to 9 hours of L.S.N. but can vary based on hospital protocols.
- A pharmacist or an R.N. will prepare the alteplase for administration. Alteplase is weight-based, so having a current patient weight on record is essential! This medication is always infused with an infusion pump and is administered as a bolus dose followed by an infusion over one hour.
- Depending on the time since “last seen normal” (L.S.N.), some patients may require neuro intervention, such as a mechanical thrombectomy. These procedures are typically done as quickly as possible to improve their chances of making a full recovery.
Option B: If the C.T. scan is positive for a bleed:
Patients with a positive scan will be started on supportive care, such as controlling their blood pressure, maintaining oxygenation, and monitoring for neurological deficits.
Further, the bleed will be checked with additional imaging studies, such as an M.R.I. or M.R.A.
The patient may also need surgery to control the bleeding if severe enough.
Knowing the signs and signs of stroke is essential. Recognizing them quickly can help you save someone’s life by calling a stroke alert. Every second counts! When in doubt, dial 911! The medical staff will take it from there.
Things you can do to ensure patient safety are:
There are a few simple steps you can take to ensure patient safety, such as the following:
1. Educate & support the patient and their family
Providing education and emotional support for the patient and their family is essential. This may include education about the stroke and its treatment and giving support and reassurance to help them through this challenging time.
It is also essential to provide education and inspirational help to patients and their families about stroke alert procedures.
2. Monitor for worsening symptoms
Many Hospital facilities use a standardized stroke assessment called the N.I.H.S.S. (National Institute of Health Stroke Scale) to evaluate the patient’s condition every 15 minutes during the alteplase infusion and every 15 min for the first hour, then every 30 min for the next six hours, then hourly for the 8th to 24th hour.
3. Monitor vital signs
Vital signs should be monitored every fifteen minutes during the alteplase infusion and then periodically afterward. Monitoring oxygen saturation, blood glucose level, and perfusion status is also essential.
4. Administer medications as ordered.
The patient will typically receive various medications, such as antithrombotics, antihypertensives, and anticoagulants. It is crucial to be aware of the side effects of each drug and monitor for any adverse reactions.
5. Monitor laboratory values
Blood tests are usually drawn before alteplase administration and then periodically afterward. These will include tests such as C.B.C., electrolytes, and clotting studies. It is essential to be alert for any lab abnormalities with alteplase use.
6. Maintain airway patency
It is essential to ensure the patient’s airway remains open and unobstructed. This may involve positioning the head, using supplemental oxygen, or intubation.
7. Monitor for complications
Patients receiving alteplase are at risk for potential complications such as bleeding, infection, and blood clots. It is essential to monitor for any signs or symptoms of these complications.
8. Prevent aspiration
Aspiration can be a significant concern with stroke patients. Ensuring the patient is positioned correctly and their airway remains clear is essential. The use of prophylactic antibiotics may also be considered if the risk of aspiration is high.
9. Maintain optimal blood pressure and cerebral perfusion pressure.
Patients may require medications or interventions to maintain normal blood pressure and cerebral perfusion pressure. The MD will order a range for the patient’s blood pressure; maintaining it within that range is essential. If the patient consistently needs to manage B.P., he will be in the ICU probably.
By following these steps, you can help ensure that a stroke alert is managed efficiently and effectively for better outcomes for the patient.
How to suggest to others to reduce my risk of stroke?
The best stroke treatment is prevention. Several factors increase your stroke risk:
- Diabetes
- High cholesterol
- Physical inactivity/ obesity
- High blood pressure
- Heart disease
- Smoking
If you smoke – quit it. And, If you suffer from high blood pressure, diabetes, heart disease, or high cholesterol, get them under control. If you are bulky, start a healthy diet and exercise regularly.
Frequently Asked Question
What is Stroke?
A stroke, or “brain attack,” occurs when the brain doesn’t receive enough blood. This lack of blood causes brain cells in the immediate area to die because they can’t function without the oxygen and nutrients blood flow provides. The Code stroke hospital protocol assesses and manages a patient with stroke symptoms.
How Many Types of Stroke?
There are three main types of stroke:
- Ischemic (caused by a clot),
- Hemorrhagic (caused by bleeding),
- Transient ischemic attack (T.I.A. or mini-stroke).
- Ischemic strokes account for 87 % of all strokes and happen when a blood vessel that supplies the brain becomes blocked, stopping the flow of oxygen-rich blood.
- On the other hand, hemorrhagic strokes happen when a weakened blood vessel ruptures and bleeds into or around the brain.
- T.I.A.s are caused by a temporary stoppage of a blood vessel in the brain that typically resolves quickly with no permanent damage.
What is Activase?
Activase (alteplase) is a tissue plasminogen activator (tPA) type. It is the only FDA-approved medication to treat acute ischemic stroke induced by a blood clot blocking an artery in the brain. Activase breaks down the clot and restores blood flow to the affected brain area. Activase is typically administered through an IV within three hours of the onset of symptoms.
Final Thoughts
If you or someone you’re with experiences symptoms of a stroke, such as difficulty speaking, numbness or weakness on one side of the body, vision problems, or severe headache without warning, it’s essential to call for help immediately. Not all strokes are similar, and the severity can vary from person to person, so it’s best to call for help right away.
When you dial 911 or your local emergency number, the operator will likely ask questions about the individual’s symptoms to determine whether a stroke alert should be activated. Depending on your answers, the operator may recommend taking the person to the nearest hospital or activating a stroke alert to get them the help they need as soon as possible.
References:
- https://www.stroke.nih.gov
- https://catalog.ninds.nih.gov/publications/know-stroke-know-signs-act-time
- https://www.stroke.org/en/
- https://www.cdc.gov/stroke/signs_symptoms.htm
Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.