Code Stroke
note

CODE STROKE

Team Members:
Neurology Start Date/Time:
Neurology End Date/Time:
Last Seen Well Date/Time: 
CT First slice:

TNK:
TNK Bolus Time:
TNK Bolus dose:

Puncture time:
First Recanalization time:
First Recanalization TICI:
Final Recanalization time:
Final Recanalization TICI:

(BRIEF) PATIENT PROFILE:
-
-
PAST MEDICAL HISTORY:
-
MEDICATIONS (and if known allergies):
-

HISTORY OF PRESENTING ILLNESS:
-
-
SOCIAL HISTORY AND/OR FUNCTIONAL BASELINE:
-
EXAMINATION:
General exam: -
Neurologic exam: -
NIHSS Score:   /42 points
Individual Item Points:
Item 1a- Level of Consciousness: x (/3 points)
Item 1b- LOC Questions: x (/2 points)
Item 1c- LOC Commands: x (/2 points)
Item 2- Best Gaze: x (/2 points)
Item 3- Visual: x (/3 points)
Item 4- Facial Palsy: x (/3 points)
Item 5a- Motor Left Arm: x (/4 points)
Item 5b- Motor Right Arm: x (/4 points)
Item 6a- Motor Left Leg: x (/4 points)
Item 6b- Motor Right Leg: x (/4 points)
Item 7- Limb Ataxia: x (/2 points)
Item 8- Sensory: x (/2 points)
Item 9- Best Language: x (/3 points)
Item 10- Dysarthria: x (/2 points)
Item 11- Extinction and Inattention (Neglect): x (/2 points)

LABORATORY INVESTIGATIONS:

CODE STROKE IMAGING:

ASPECTS SCORE = 

IMPRESSION AND CLINICAL PLAN:

PLAN:

Stroke

Suspected Etiology:

Treatment:

TNK/EVT Inclusions and Exclusions Considerations and Details:

Workup Pending: Lipid Panel, A1C, ECHO, Holter, Outstanding repeat Imaging

Disposition:

Driving:

Medical & Critical Care Issues:

Disposition service (Medicine/ICU); other medical issues:

Family/SDM Update and Discussions:
-All discussions occurred using clear language and plain terms, opportunity was provided for the SDM to ask questions, and their questions were answered, they were satisfied with the answers provided.

** IF BEING REPATRIATED **
-Admit

-Consult Internal medicine

-Consult neurology, if ongoing deficits concerning for stroke

-Please rule out co-present medical issues such as cardiac ischemia, sepsis, metabolic abnormalities

-Repeat Imaging - CT head in 24H and/or MRI brain to rule out infarct and/or assess for evolution of changes; proceed with stroke workup as applicable, including metabolic profile, 2D ECHO, Holter and/or Telemetry. Tests at the discretion of Emergency Medicine/Internal Medicine/Neurology as applicable

-Medical issues:

-Call back Stroke service if any questions or concerns; stroke on-call