Acute Stroke

Question 1

What are the two types of stroke? What percentage of all strokes do each make up?

Answer 1

Ischemic stroke - 87%

Hemorrhagic stroke - 13%

Question 2

What are the four links in the Stroke Chain of Survival?

Answer 2

• Rapid recognition and reaction to stroke warning
• Rapid EMS dispatch
• Rapid EMS transport and prearrival notification to the receiving hospital
• Rapid diagnosis and treatment in hospital

Question 3

What are the 8 D’s of Stroke Care?

Answer 3

Detection
Dispatch
Delivery
Door
Data
Decision
Drug
Disposition

Question 4

Common signs and symptoms of stroke

Answer 4

Sudden weakness or numbness of the face, arm, or leg, especially on one side of the body
Sudden confusion
Trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking
Dizziness or loss of balance or coordination
Sudden severe headache with no known cause

Question 5

What are the three physical findings in the Cincinnati Prehospital Stroke Scale?

Answer 5

Facial droop - have patient smile or try to show teeth
Arm drift - have the patient close eyes and hold both arms out, with palms up
Abnormal speech - have patient say “You can’t teach old dogs new tricks”

Question 6

6 things to do while en route with potential stroke victim

Answer 6

Support ABCs - provide supplemental oxygen to hypoxemic patients or those with unknown oxygen saturation
Perform stroke assessment - CPSS
Establish time - when patient was last known to be normal
Triage to stroke center - if possible, bring a witness
Alert hospital - provide prearrival notification to receiving hospital
Check glucose - self explanatory