CVA "Stroke" Standard

Question 1

Consider potentially serious conditions that may mimic a stroke:

Answer 1

1. drug ingestion (cocaine)
2. hypogylcemia
3. severe hypertension, hypertensive emergency
4. CNS infection (meningitis)

Question 2

When performing your secondary survey, what are the head/neck assessments needed: (4 diff things)

Answer 2

• facial symmetry
• pupillary size, equality and reactivity
• abnormal speech and
• presence of stiff neck

Question 3

When performing your secondary survey, what are the CNS assessments needed: (2 diff things)

Answer 3

• abnormal motor function (hand grip strength arm/leg movement/drift )
• sensory loss

Question 4

When performing your secondary survey, what is the last thing (c) you need to assess?

Answer 4

incontinence of urine/stool

Question 5

To ensure adequate support for the patient’s body/limbs, during pt movement what should we do?

Answer 5

place extra padding and support beneath affected limbs

Question 6

What are the potential problems we should be ready for?

Answer 6

• possible airway obstruction
• decreasing LOC
• seizures
• agitation, confusion, or combativeness

Question 7

If pt’s respirations is inadequate, what do we need to do? And what should we attempt to maintain the ETCO2 at??

Answer 7

VENTILATE!!

attempt to keep ETCO2 35-35mmHg

Question 8

What is the RATE we should hyperventilate at?

Answer 8

1:3 (20 per min)

Question 9

If a pt’s symptoms present within 24 hours of stroke symptom onset, what assessment should we perform?

Answer 9

LAMS score card

Question 10

If a pt has a LAMS score of 4 or MORE what CTAS are they and where should we bring them?

Answer 10

CTAS 2
Stoke Centre

Question 11

To take stroke bypass to the stroke centre, pt must have ONE OR MORE of these symptoms:

Answer 11

a. inapporiate words or mute
b. slurred speech
c. unilateral arm weakness or drift
d. unilateral facial droop
e. unilateral leg weakness or drift

Question 12

What is the MAX amount of time a pt can be presenting with stroke symptoms?

Answer 12

6 hours or less

Question 13

What are the CONTRAINDICATIONS to the stroke bypass protocol? (7 of them)

Answer 13

• CTAS 1 or uncontrolled ABC’s
• Stroke symptoms resolved prior to EMS arrival
• Seizure when symptoms occurred or witness by EMS
• Blood glucose <3 mmol/L
• GCS <10
• Terminally ill or palliative care
• more than 2 hours to the stroke centre

Question 14

If symptoms resolve en route to the stroke center what do we do?

Answer 14

CONTINUE EN EROUTE