|Stroke is the third leading cause of death in the United States. For effective treatment the early identification and rapid assessment of the patient with stroke symptoms is critical. This includes the patient and/or family members recognizing the early warning signs; the ambulance EMT/paramedic staff recognizing and responding to the presence of stroke symptoms; and the Emergency Room/hospital staff rapidly assessing and treating the patient with stroke symptoms.|
2010 Recommendations of the Stroke Workgroup
Act 61 of 2009 charged the Vermont Association of Hospitals and Health Systems with convening a workgroup of neurologists, emergency department (ED) physicians and representatives of the American Heart Association to make recommendations to improve acute stroke care. The Stroke Workgroup met for two years and issued a final report in November 2010.
A number of specific “next steps” were identified in the report. The most significant of these was the incorporation of the workgroup-developed tools and materials into local community ED processes. To accomplish this, the management of the project was turned over to the Vermont Program for Quality in Health Care an organization with quality improvement expertise and resources.
National Stroke Association
Resource for patients, families and professionals for stroke prevention and early detection and treatment.
Center for Disease Control
Education and information about Stroke
resource for stroke prevention recommendations
In December 2010 VPQHC staff began to inventory the ED process for assessing stroke symptoms in all hospital emergency rooms in Vermont with the goal of protocolizing the Stroke Workgroup recommendations. By July of 2011, all EDs had adopted the recommendations and were working on standardizing the charting of this process.
Recommendations for the early recognition, assessment and ED stroke alert by the emergency medical system was also included in the recommendations. Currently all districts are involved with training in the use of the stroke assessment tool and are beginning to use the stroke alert process.
In addition to the standardization of assessment and treatment of strokes in the ED, VPQHC identified resources to assist health care professionals and the general public to understand the latest evidence on assessing and treating stroke symptoms.
An audit of medical records was done and a summary was presented at the workgroup meeting.
Ruby Merali, MS, APRN, Stroke Nurse Practitioner
Fletcher Allen Health Care
Stroke Awareness Month - May 2011
view video - click here
NIH Stroke Scale/Score (NIHSS)
MDCalc, an online resource for medical equations and assessment algorithms