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The goal of initial care in the hospital emergency department is to rapidly assess, stabilize, image, and treat stroke patients. With prehospital notification, the stroke team can be activated in advance. This section outlines the typical care and flow of the process, rapidly evaluating a potential stroke patient in the emergency department setting. Knowledge of this process will solidify that time is a critical factor in caring for any patient with stroke symptoms, even those with a remote possibility, in the most expeditious manner possible.
As in all emergency situations, a rapid assessment of the ABCs is carried out, a focused history and physical is then performed, with emphasis on the neurologic evaluation. A rapid determination of the patient's eligibility for thrombolytic therapy is carried out. CT imaging is the modality of choice due to widespread access and speed of use. A non-contrast head CT should be performed as soon as possible. The presence of hemorrhage drastically changes the treatment algorithm. Early signs of infarction also portend to a worse prognosis and poor functional outcome. An experienced physician should interpret the CT scan in order to minimize errors in reading the CT images. [40] | | | | | | |
