Code Stroke

CODE STROKE

Team Members:

Neurology Start Date/Time:

Neurology End Date/Time:

Last Seen Well Date/Time:  

CT First slice: 

TPA:

• TPA Bolus Time:

• TPA Bolus dose:

• TPA Infusion dose:

Puncture time: 

First Recanalization time: 

First Recanalization TICI:

Final Recanalization time: 

Final Recanalization TICI:

Patient Profile:

Past Medical History:

History of Presenting Illness:

Social History and Functional Baseline:

Physical Examination

General exam:

Neurologic exam:

Laboratory Investigations:

Imaging:

ASPECTS SCORE = 

Impression:

PLAN:

1)Stroke

Suspected Etiology:

Treatment:

TPA/EVT Inclusions and Exclusions Considerations and Details:

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

Disposition:

Driving:

2) Medical & Critical Care Issues:

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

3) Family/SDM Update and Discussions: