Stroke & DNR Protocol Flashcards
F.A.S.T. for Stroke
Face Drooping
Arm Weakness
Speech Difficulties
Time to Call
Which CTAS level and above is a contraindication for Acute Stroke Protocol?
CTAS Level 1 and/or uncorrected airway, breathing or circulatory problem.
Under what circumstances will an Airway, Breathing, or Circulatory problem NOT be a contraindication for Acute Stroke Protocol?
Problem was corrected prior to transport
When will a patient with strokes symptoms that have RESOLVED, still qualify to be transported to a Designated Stroke Centre?
Patients whose symptoms improve significantly or resolve during transport will continue to be transported to a
Designated Stroke Centre.
Blood Sugar <3 mmol/L is a contraindication for transport to a Designated Stroke Centre unless…
Symptoms persist after correction of blood glucose level, the patient is not contraindicated.
What Glascow Coma Scale (GSC) level is a contraindication for Acute Stroke Protocol?
Glasgow Coma Scale <10.
What duration of out of hospital transport is a contraindication for Acute Stroke Protocol?
Duration of out of hospital transport will exceed two hours
What about a patient with a DNR would trigger a contraindication for Acute Stroke Protocol?
Terminally ill or palliative care patients are contraindicated for…
When is a seizure a contraindication for Acute Stroke Protocol?
Seizure at onset of symptoms or observed by paramedics.
DNR
For the purposes of the DNR Protocol, CPR includes
All the things!
* compressions
* defib
* vent
* airways
* intubation
* pacing
* resuscitation drugs
DNR
What does a valid DNR mean for the paramedic
paramedic will not initiate any ‘CPR’ related interventions
DNR
Valid DNR forms has this one key thing prior to completion
pre-printed serial number
DNR
A completed DNR form contains these key things
- pt first and last name, and
- Checked box for condition met for the DNR
- Signors key details:
* check box with medical designation of signor
* Printed name
* signature of signor - date
who/why/authority/when
DNR
Can a paramedic accept a copy of the DNR?
Yes, a valid copy of the DNR is as acceptable as the original
DNR
When will a paramedic ignore the DNR
- not complete
- pt expresses a wish to be resusitated if they arrest (can be clear or ambiguous)
DNR
With a valid DNR, what care must the paramedic provide?
PT management necessary for comfort or alleviate pain as req’d by the pt medical condition
DNR
Upon death, the paramedic shall…
1.note the time
2. notify CACC/ACS
3. follow deceased pt standard
Deceased PT Standard
Code 5 - list acceptable types
- decap, transection, visible decomp, putrefaction; or
- VSA &
* grossly charred
* open head/torso
* gross rigor
* dependent lividity