3020

Question 1

Acute Stroke
Medical Director Review Date 2-15-2018
3020
JFRD STROKE ALERT POLICY
1. Assess patient using the _____ Prehospital Stroke Scale (CPSS) to determine the PRESENCE of a stroke
* ___ ___ (show teeth or smile)
* ___ ___ (close eyes and hold out both arms)
* ____ abnormal (inability or difficulty speaking)
* ___ of ___ (last seen normal?)

2. Perform the Los Angeles Motor Scale (LAMS) assessment to determine the _____ of the stroke:
3. If the patient’s blood glucose is ___ mg/dL, proceed with assessment. Otherwise, administer 12.5 grams D50W. If stroke symptoms persist despite treatment, continue with assessment.
4. After identifying stroke alert criteria, determine closest, most appropriate Stroke Center.
   * Comprehensive Stroke Center
   - LAMS score of __ or __ (indicative of a potential large ___ ___ that requires ___ ____) with onset up to ___ hours. After ___ hours, any hospital is appropriate

• LAMS score of __, __ or __ with onset up to __hours. After __ hours, any hospital is appropriate
• Patient wakes up with stroke ____
• Suspicion of ___ hemorrhage/___ hemorrhage, sudden severe headache (“Thunderclap Headache”) or sudden decrease in ___
• Current or recent __ bleeding
• Trauma, surgery, or invasive procedure within past __ months
• Currently on ____
• Bleeding disorders (e.g., low platelets, cirrhosis)
• Primary Stroke Center
• LAMS score of __, __ or __ with onset up to __ hours
• Does not meet Comprehensive Stroke Center requirements as listed above

5. Notify FRCC of Stroke Alert, destination, LAMS score, onset time, and ETA.

Comprehensive Stroke Centers
 UF Health Hospital
 Mayo Clinic
 Baptist Medical Center-Downtown
 Orange Park Medical Center
Primary Stroke Centers
 Baptist Medical Center-South
 Baptist Medical Center-Beaches
 Baptist Medical Center-Nassau
 St. Vincent’s Medical Center-Riverside
 St. Vincent’s Medical Center-Southside
 Memorial Hospital

Answer 1

CINICINNATI

FACIAL DROOP
ARM DRIFT
SPEECH
TIME OF ONSET

SEVERITY

> 50

4 5 . VESSEL . OCCLUSION
MECHANICAL THROMBECTOMY
24
24

1 . 2 . 3 . 6 . 6

SYMPTOMS
SUBARACHNOID . INTERCRANIAL

LOC
GI
3
ANTICOAGULANTS

1 . 2 . 3 . 2