Direct to CT Stroke Care

This is the process:

1. EMS brings in potential stroke patient
2. Charge Nurse assigns the team and pulls the provider for an evaluation
3. EMS stops in front of the charge desk where the patient is evaluated by:
   • Registration
   • ED nurse
   • ED provider
     • Assess that patient is having stroke symptoms requiring stroke work up (brief neuro exam, NOT full NIHSS)
   • ED provider and RN go through check list to ensure
     • Vital signs stable for CT transport
     • Glucose safe for CT transport
     • Airway intact
4. Patient goes to CT scan on EMS stretcher, transfers to NWH weighted stretcher, weight is checked outside of CT scan.  RN enters weight and allergies.
5. RN calls charge NR or ED provider to advise that weight and allergies are entered
6. ED provider enters the stroke orders (This means that after you evaluate a code stroke in the hallway, 2 or 3 minutes later, you’ll be notified to place the orders.  So please do not immediately get involved with a complex situation until you have entered the stroke orders)
7. Patient returns to the assigned room and usual stroke care follows.

See overview of evaluation pathways in this swim lane diagram.