Strokes

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Transcript

The next video is the stroke video, we'll just touch on the highlights of the stroke video for you. We have to determine Is it an ischemic stroke? Or is it hemorrhagic? So is it a block or is it a bleed? Now, what's the best way for us to tell if it's a block or a bleed? What's the most important diagnostic test that we need to give our patient?

So we can determine that if you said CT or CAT scan, that is correct, they're going to get a CT no contrast immediately. And what that's going to do is rule out that bleed typically won't show a block or ischemia but it will show a bleed so we can use it as a rule out tool. One of the things to consider is how to determine if the patient is having a stroke. Just remember the fast pneumonic. F stands for facial droop. A stands for arm drift, weakness, numbness, S stands for slurred speech, and then t stands for time.

When did this happen? When was the patient's last seen normal, keeping in mind that the American Heart Association, his recommendation for fiber analytic therapy, or TPA is going to be four and a half hours from the onset of symptoms. If it's been more than four and a half hours, they're probably not going to be a candidate for that fibrin lytic medicine. But we do have other treatments or other other treatments available to them. So just remember the four and a half hour rule. Another thing to keep in mind is they're typically going to be hypertensive.

And the physician or the attending will probably want to keep them in a hypertensive phase. And that is just so they can keep blood flowing perfusion to the brain, and also keeping that clot if that's what it is right where it is without moving it around. So just just remember with strokes, primary diagnostic test is going to be CT, and also keeping in mind about how important that is. If you're driving a patient to a hospital and you call ahead and they say hey, our CT scanners down for some reason We don't want to just dump them and run we have to find another hospital that has CT capability because we have to determine if it's a block or a bleed.

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