Transcript EMS Education

Primary Stroke Center
EMS Training
Union Hospital, Inc.
Terre Haute
Role of EMS in Rapid
Response
• Notification-If patient presents as symptomatic or
unstable, announce to medical control via IHERN or
other contact method as a “Stroke Alert”.
• The RRT must be at the bedside within 15 minutes of
the alert; the 15 minutes includes the time EMS
advises the facility of a stroke alert.
Evaluation of Acute Stroke
• Pertinent patient questions that need to be
documented for ED team:
– Definite time of onset of signs or symptoms—be precise
– Any loss of consciousness or mental status changes
– Any neurological deficits: seizures, unilateral weakness,
grip, smile
– Any slurred speech, blurred vision, or aphasia
– Past CVA or TIA
– Pertinent medical history: has pt recently fallen or had
any head trauma
– Current medications with time anti-coagulants last taken
Assessment of Acute Stroke
• The Cincinnati Pre-hospital Stroke
Scale
– Facial Droop
– Arm Drift
– Abnormal Speech
Stroke Mimics
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Hypoglycemia
Alcohol & Drug Intoxication
Postictal Hemiparesis
Complicated Migraines
Treatment for Acute Stroke
• Tissue Plasminogen Activator (tPA) –
Must be administered within 3 hours
of symptom onset for optimal
outcomes.
• Recognition of acute signs and
symptoms in the pre-hospital phase
could greatly enhance the
intervention and outcome of these
patients.
tPA-Exclusions
• Patient exclusion for possible TPA
will expedite ED treatment:
– History of internal bleeding
– History of past CVA
– Recent (within 2 months) trauma or
surgery
– Severe hypertension
– Known bleeding disorders
– Pregnancy