STROKE ROTATION ORIENTATION
Please Checkout Pharmacy Services for additional Important Information from Our Pharmacy Team, regarding the general care of stroke patients and How-To perform Medication Transfer Reconciliation on admitted or transferred patients!
See ward patient under the stroke service first before the day gets busy
Phone-in consults to other services early in the day
On admission use Templates/Work-flows to help standardize the admission process and pending investigations; allow your admission note to transition seamlessly to a progress note, and ultimately a discharge note
Keep the sign-out list updated
Provide daily handover to Orange Team and Receive daily handover
Key points to consider to made for a great stroke rotation
excellence in patient care
efficient and concise handover
disposition and discharge planning
See the in-patients first (i.e. patients admitted under the stroke service on B4 or bed-spaced to other wards)
Designate MD Roles in the Morning - MD1, MD2
Daily check of Medication Reconsiliation on Sunnycare
Provide handover: On-call Neuro resident, Orange Team resident/fellow, also Receive Handover
Sr/designate to handover to Orange Team Daily
Sr/designate to receive Handover from Orange Team Daily
Update the Sign-out List daily
Flow of Stroke Patients (during the acute Code Stroke) phase:
Flow diagram of patients during a Code Stroke activation. This is meant as a general guide/outline of our current processes. Please note that each individual case needs consideration.
First questions to ask during code stroke
Last seen well?
Did you bypass a hospital? (repatriation implication)
acute medical history, clinical course on scene, glucose, BP; any deterioration on transport
TPA contraindications - antiplatelets, anticoagulants, recent surgery, recent trauma, recent stroke/TIA, malignancy, etc...
If the patient looks unstable ask for help early - ED/Emerg MD or Critical Care consult - ED first to stabilize the patient/airway management
Stroke Rotation - Introductory Podcasts
The following are a series of short audio podcasts with some introductory information regarding your stroke rotation and how things generally work. The final topic "Summary and Key points" ends the segments and contains some general guidelines regarding workflow.