INDEX

Strokes (Code Stroke)

Table of Contents:

• Indications & Types of Code Strokes

• Code Stroke General Details

• Highlands (HED) & Gardendale (GED)

Cross References:

• None

There are 2 types of Code Stroke that can be paged. If you have trouble getting through to the operator, there is a direct line for Code Strokes at 4-2244.

1. "Code Stroke"

   • Symptom onset is less than 6 hours (UED)

   • Symptom onset is less than 24 hours (HED & GED)

2. "Code Stroke Extended" (UED Only)

   1. Symptom onset is between 6 and 24 hours

   2. All wake up strokes

Remember, it is NOT a TIA unless symptoms have completely resolved.

• Activate the "UED Stroke" PowerPlan.

• Patients should go ASAP for head CT if no emergent stabilization is required.

• Clevidipine or nicardipine are the preferred first-line agents for BP control (not IV labetalol). Both are located in the UED Stroke PowerPlan.

• Attending-to-attending discussion prior to TPA administration.

• TPA order needs to be in the computer before it is administered.

• Please activate the TPA Monitoring PowerPlan if TPA is used.

1. Call the operator and activate a “Code Stroke” for any patient with stroke symptoms within 24 hours of onset. (See below for subacute strokes).

2. Initiate the "UED Stroke" PowerPlan with the “eMed Stroke” order.

3. Call the Teladoc number 205-975-5552. Ensure the nurse staff is establishing the telemedicine connection with the on-call neurologist, who will perform a virtual assessment and discuss treatment and disposition with the ED physician.

4. If ER-to-ER transfer, contact the Pod 4 physician (6-3339) to make them aware.

For subacute strokes (over 24 hours from symptom onset), please use the tele-stroke services for consults and avoid transferring to UED. Use the same “eMed Stroke” order, which can be ordered independently of the PowerPlan.

KEYWORDS: stroke, code stroke, neuro, neurology