Stroke Ward Guidelines

2021 (revised July 2022) Stroke Unit/Ward Admission Guidelines - These are admission guidelines for NVU Stroke Unit/Ward.

*This guideline does not apply to NVU Level 1 or Level 2*

1) Acute Stroke consults within 24H of symptom onset

Please refer to Code Stroke Protocols for 0-6 Hrs (Early time window) and 6-24 Hrs (Late time window).

If NOT a Code Stroke, proceed with usual care for Subacute Stroke as outlined below

2) Subacute Stroke consults NOT meeting criteria for Code Stroke Protocols – Consult Stroke Neurology 1st – IF any of the following are TRUE:

- imaging positive stroke explaining the symptoms
- imaging negative, but the patient has a clear stroke syndrome/deficit on exam as supported by history and assessment (e.g. early lacunar stroke may be negative on imaging but the patient has a clear stroke syndrome, e.g. face+arm+leg weakness)

Other Query Subacute Stroke consults, where imaging negative or who don’t have a clear stroke syndrome, please consult Internal Medicine. When/if stroke is confirmed, stroke will accept and transfer care, to the NVU Stroke ward for comprehensive allied health care. Only exceptions include patients who need higher levels of care (level 1,2,3 ICUs), or if there is a more urgent/precedent primary medical issue.

Medical Admission Criteria – these are the stroke unit/ward admission guideline, proposed by Dr. Khosravani, discussed and approved with Drs. Lynfa Stroud, Don Livingstone, Rick Swartz, Brian Murry. These were formalized and put into place 2021 July 1st; (proposed) revised June 8, 2022

Intranet Clinical Stroke Protocols - please follow this LINK*

• The above link provides hospital-specific protocols including, Code Stroke, TNK orders, Admission orders (which should not be used in paper format - use the electronic version), and supporting guidelines. Also, there are hospital-specific guidelines for management of anti-coagulation, reversal of blood thinners and TNK, and other useful information.

• * Please note that you will need your network Login and Password to access this information.