Stroke

Question 1

You suspect a stroke, what tests need to be run?

Answer 1

Labs, bedside glucose, EKG, Neurologic screen, CT head w/o contrast

Question 2

NIH stroke scale score that suggests stroke impairment.

Answer 2

• > 25 Very severe neurological impairment
  – 15-24 Severe impairment
  – 5-14 Moderately severe impairment
  – <5 Mild impairment
  – Adams, HP, et al. (1999). Neurology: 53: 126-131.
  • A 2-point (or greater) increase on the NIHSS
  administered serially indicates stroke progression

Question 3

A head CT shows hemorrhagic stroke, what med should be given?

Answer 3

ASA

Question 4

A head CT shows ischemic stroke, what med should be given?

Answer 4

After checking fibrinolytic exclusions (STEMI, new LBBB on ekg, etc), give rTPA w/in 60 minutes of arrival

Question 5

If a pt w/ ischemic stroke is not a candidate for rTPA, what med should be given?

Answer 5

ASA