1. Code Stroke Process 3. MD evaluation < 10 minutes Brief neuro exam
Confirm Last Known Well Time (LKW)

2. Code Stroke Process
4. Notify UC Stroke Team < 15 minutes
Patient demographics
POC Glucose
LKW
What’s wrong?

3. Code Stroke Process 5. Patient to CT scan < 25 minutes
6. CT Interpretation < 20 minutes (45 minutes from start of Code Stroke)
Hemorrhage → consult Neurosurgery
(981-BEDS)
No Hemorrhage/Acute Ischemic Stroke (AIS) → evaluate if patient is a candidate for TPA

4. Code Stroke Team CODE STROKE Responders =
Code Blue Team + ED Charge RN
ED Charge RN to assist with baseline NIH
ICU RN will respond to floor 2 and above
CVU RN will respond to 1st floor and below
ICU or CVU & Primary RN will accompany bedside nurse to CT (SBAR)
PCU RN will document

5. Code Stroke Team Roles Primary RN Collects blood sugar Obtains VS
Determines LKW
SBAR to team
Transports to CT with ICU RN

6. Code Stroke Team Roles Unit Charge RN ED Charge RN Completes NIHSS*
Places patient on Zoll monitor
Notifies attending/consulting MDs
Notifies family
ED Charge RN
Completes NIHSS*
Ensures compliance with stroke algorithm & time frames
* PCU RN will document NIHSS assessment as ED RN does not have inpatient CarePath access

7. Code Stroke Team Roles ICU/CVU RN Hospitalist
Transports pt to CT with primary RN
Reports labs & CT result to hospitalist
If ordered, starts tPA (Alteplase) within 60 minutes
If hemorrhagic, Consults Neurosurgery
Hospitalist
Evaluates patient within 10 minutes
Reviews glucose result
Provides orders for labs, CT
Calls UC Stroke Team within 15 minutes
Reviews inclusion/exclusion criteria
Reports labs & CT result to UC Stroke Team

8. Code Stroke Team Roles PCU RN Clinical Administrator PCA
Documents events in CarePath using Code Stroke Narrator
Clinical Administrator
Ensures MD call to UC Stroke team within 15 minutes
Facilitates patient transfer
PCA
Brings glucometer & WOW to room
Brings patient’s softchart and facesheet to room
Rounds on other patients

9. Code Stroke Team Roles Radiologist Pharmacist
Calls CT result to primary RN
Pharmacist
Prepares tPA (Alteplase) and delivers to ICU within 15 minutes of CarePath order
Reviews dosage with ICU RN at bedside prior to administration

10. Code Stroke - Documentation
MUST Document in a Code Stroke:
Last known well (LKW)
Blood Glucose
Full set of vitals
Full NIHSS – in EPIC flowsheet
“What’s wrong?”...why did you call a Code Stroke??