{"id":160,"date":"2018-10-22T15:30:20","date_gmt":"2018-10-22T15:30:20","guid":{"rendered":"https:\/\/www.proacls.com\/wiki\/?p=160"},"modified":"2018-12-12T22:13:19","modified_gmt":"2018-12-12T22:13:19","slug":"stroke","status":"publish","type":"post","link":"https:\/\/www.proacls.com\/wiki\/acls-algorithms\/stroke\/","title":{"rendered":"Stroke Algorithm"},"content":{"rendered":"\t\t\t<div \n\t\t\tclass=\"yotu-playlist yotuwp yotu-limit-min yotu-limit-max   yotu-thumb-169  yotu-template-grid\" 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>\n\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-wrapper-player\" style=\"width:600px\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-player\">\n\t\t\t\t\t\t\t<div class=\"yotu-video-placeholder\" id=\"yotu-player-6a0b01613d58e\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"yotu-playing-status\"><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"yotu-pagination yotu-hide yotu-pager_layout-default yotu-pagination-top\">\n<a href=\"#\" class=\"yotu-pagination-prev yotu-button-prs yotu-button-prs-1\" data-page=\"prev\">Prev<\/a>\n<span class=\"yotu-pagination-current\">1<\/span> <span>of<\/span> <span class=\"yotu-pagination-total\">1<\/span>\n<a href=\"#\" class=\"yotu-pagination-next yotu-button-prs yotu-button-prs-1\" data-page=\"next\">Next<\/a>\n<\/div>\n<div class=\"yotu-videos yotu-mode-grid yotu-preset yotu-preset-gplus yotu-column-6 yotu-player-mode-large\">\n\t<ul>\n\t\t\t\t\t<li class=\" yotu-first\">\n\t\t\t\t\t\t\t\t<a href=\"#MLnqJEgUWmE\" class=\"yotu-video\" data-videoid=\"MLnqJEgUWmE\" data-title=\"What is Stroke?\" title=\"What is Stroke?\">\n\t\t\t\t\t<div class=\"yotu-video-thumb-wrp\">\n\t\t\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"yotu-video-thumb\" src=\"https:\/\/i.ytimg.com\/vi\/MLnqJEgUWmE\/sddefault.jpg\" alt=\"What is Stroke?\">\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"yotu-video-title\">What is Stroke?<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-video-description\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\n\t\t\t\t\t\t<li class=\" yotu-last\">\n\t\t\t\t\t\t\t\t<a href=\"#HVJLn70jfYM\" class=\"yotu-video\" data-videoid=\"HVJLn70jfYM\" data-title=\"Stroke Teaching (ACLS Algorithms)\" title=\"Stroke Teaching (ACLS Algorithms)\">\n\t\t\t\t\t<div class=\"yotu-video-thumb-wrp\">\n\t\t\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"yotu-video-thumb\" src=\"https:\/\/i.ytimg.com\/vi\/HVJLn70jfYM\/sddefault.jpg\" alt=\"Stroke Teaching (ACLS Algorithms)\">\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"yotu-video-title\">Stroke Teaching (ACLS Algorithms)<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-video-description\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\n\t\t\t\t<\/ul>\n<\/div><div class=\"yotu-pagination yotu-hide yotu-pager_layout-default yotu-pagination-bottom\">\n<a href=\"#\" class=\"yotu-pagination-prev yotu-button-prs yotu-button-prs-1\" data-page=\"prev\">Prev<\/a>\n<span class=\"yotu-pagination-current\">1<\/span> <span>of<\/span> <span class=\"yotu-pagination-total\">1<\/span>\n<a href=\"#\" class=\"yotu-pagination-next yotu-button-prs yotu-button-prs-1\" data-page=\"next\">Next<\/a>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n<p>&nbsp;<\/p>\n<h2>What is a Stroke<\/h2>\n<p><span style=\"font-weight: 400;\">The word stroke refers to an acute neurologic impairment following interruption of blood supply to a specific area of tissue in the brain.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Two major types of stroke are: <\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\"><strong>Ischemic stroke<\/strong>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Accounts for almost 87% of all strokes<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Usually caused by an embolism, which occludes an artery, affecting the subsequent tissue of the brain of which that particular artery affects<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"><strong>Hemorrhagic stroke<\/strong> <\/span>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Accounts for close to 13% of strokes<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Occurs when a blood vessel in the brain ruptures and bleeds into the surrounding tissue, causing damage<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">In the cases of suspected or confirmed hemorrhagic stroke, fibrinolytic therapy is contraindicated and anticoagulants should not be used<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>Stroke Treatment<\/h2>\n<p><span style=\"font-weight: 400;\">Stroke remains a leading cause of death in the United States. Early recognition and treatment of acute ischemic stroke is important, because IV fibrinolytic treatment should be provided as soon as possible.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In stroke cases, an ECG should not take priority over obtaining a computed tomography (CT) scan. There is no arrhythmia specific for or related to stroke, but an ECG may help identify evidence of the cause of an embolic-type stroke. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many stroke patients demonstrate arrhythmias, but if the patient is hemodynamically stable, treatment of such arrhythmia is usually not indicated. Cardiac monitoring should be maintained during the first 24 hours of observation for patients who have experienced acute ischemic stroke so that atrial fibrillation and other potentially life-threatening arrhythmias may be detected.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The goal of stroke care is to minimize brain injury and maximize the recovery. The American Heart Association (AHA) and American Stroke Association have developed a Stroke Chain of Survival. It correlates actions to be taken by patients, family members, and healthcare providers in order to maximize stroke recovery. <\/span><\/p>\n<h3><span style=\"font-weight: 400;\">The following are the established links: <\/span><\/h3>\n<ol>\n<li><span style=\"font-weight: 400;\"> Rapid recognition and reaction to stroke warning signs<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Rapid EMS dispatch<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Rapid EMS system transport and pre-arrival notification to the receiving hospital<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Rapid diagnosis and treatment upon arrival to the appropriate hospital<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Patients with acute ischemic stroke have a \u201ctime-dependent benefit\u201d for fibrinolytic therapy. The critical time period for administration of IV fibrinolytic therapy begins with the onset of symptoms. <\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Critical time periods from hospital arrival are as follows: <\/span><\/h3>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Immediate general assessment should be 10 minutes \u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Immediate neurologic assessment performed within 25 minutes \u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Acquisition of CT of the head is to be within 25 minutes, while interpretation of the CT scan should be complete within 45 minutes <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Administration of fibrinolytic therapy should be within 60 minutes from the time of \u00a0Emergency Department arrival<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Administration of fibrinolytic therapy may be delivered as late as 3 to 4.5 hours timed from onset of select patients\u2019 symptoms <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Administration of endovascular therapy should be 6 hours timed from onset of select patients\u2019 symptom<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Admission to a monitored bed should be within 3 hours<\/span><\/li>\n<\/ul>\n<h2>Adult Suspected Stroke Algorithm<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-397\" src=\"https:\/\/www.proacls.com\/wiki\/wp-content\/uploads\/2018\/10\/stroke.jpg\" alt=\"Adult Suspected Stroke Algorithm\" width=\"1500\" height=\"1853\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; What is a Stroke The word stroke refers to an acute neurologic impairment following interruption of blood supply to a specific area of tissue in the brain. Two major types of stroke are: Ischemic stroke Accounts for almost 87% of all strokes Usually caused by an embolism, which occludes an artery, affecting the subsequent [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[8],"tags":[],"class_list":["post-160","post","type-post","status-publish","format-standard","hentry","category-acls-algorithms"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Stroke Algorithm - ACLS Wiki<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.proacls.com\/wiki\/acls-algorithms\/stroke\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Stroke Algorithm - ACLS Wiki\" \/>\n<meta property=\"og:description\" content=\"&nbsp; What is a Stroke The word stroke refers to an acute neurologic impairment following interruption of blood supply to a specific area of tissue in the brain. 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