1. Stroke and Code Brain Attack “Act Fast When the Brain Attacks”

2. Objectives Describe the warning signs of a stroke. Describe the process of a Code Brain Attack page at LHS. Identify the 3 designated Stroke Units at LHS.

3. Introduction One of our goals at LHS is to become a certified Primary Stroke Center through the Joint Commission. A Stroke Center is a multidisciplinary approach to the care of the Stroke Patient with a focus on early diagnosis and prompt treatment. This brief tutorial will review basic stroke information and provide steps on the new Code Brain Attack process.

4. A Stroke is an Emergency! Stroke is the 3 rd leading cause of death and disability in the United States. It is estimated that in 2008; Americans will pay over $65.5 billion dollars in health care related cost due to stroke and its disability. Early recognition and treatment can help lessen the burden of long term effects of an acute stroke and increase the chances of an improved outcomes for survival.

5. Stroke Warning Signs Sudden dizziness or loss of balance or coordination Sudden vision problems in one or both eyes Sudden weakness or numbness in your face, arm or leg, especially on one side of your body Sudden severe intense headache with no known cause Sudden speaking problems, difficulties or confusion

6. When it comes to Stroke: Think- F.A.S.T Think F.A.S.T. Every second counts, because time lost is brain lost. Know these warning signs of a stroke: – F= Face-ask the person to smile. Does one side of the face droop? – A= Arm- Ask the person to raise both arms. Does one arm drift downward? – S= Speech-Ask the person to repeat a simple Phrase” the sky is blue”. Does the speech sound slurred or strange? – T=Time- If you notice any of these signs, then it’s time to call Code Brain Attack (or 911 if outside the hospital setting)

7. Think F.A.S.T for a Stroke

8. A Stroke is an Emergency! Patients that experience an acute stroke within 3 hours of symptom onset are eligible for treatment with an FDA approved medication called ALTEPLASE or TPA. This medication will help dissolve the blood clot causing the injury to the brain.

9. Code Brain Attack Code “Brain Attack” is a new overhead emergency alert page at Lake Hospital System indicating an Acute Stroke patient in either the Emergency Department or the inpatient areas.

10. Code Brain Attack A Brain Attack is the American Stroke Association’s term for an Acute Stroke. A Brain Attack is a Medical Emergency. Activating an overhead page alerts the hospital team that a patient is experiencing stroke like symptoms and needs immediate assessment and intervention. By activating the Code Brain Attack you are increasing the patients likelihood of improved outcomes.

11. Code Brain Attack The Code Brain Attack page will be used when patients present to the emergency department with acute stroke symptoms. Code Brain Attack will also be used within the hospital setting when a change in the patients condition may indicate stroke like symptoms.

12. Who responds to a Code Brain Attack The following team will respond to a Brain Attack Notification: – Respiratory Therapist – Administrative Coordinator – Security Officer- assist with elevator hold – In Patient locations only: Hospitalist- in patient locations only I-Team ( ICU Nurse and Resp. Therapist)

13. How to activate a Code Brain Attack Same process for calling an I-Team  Dial 4411- priority emergency line direct to operator  State “Code Brain Attack” and the location i.e.: Brain Attack West Emergency Room i.e.: Brain Attack room 400

14. LHS Stroke Program Our goal at Lake Hospital System is to become a certified Primary Stroke Center through the Joint Commission. A Stroke Center is a multidisciplinary approach to the care of a stroke patient with a focus on early diagnosis and prompt treatment. Beginning in Fall of 2008 a multidisciplinary team has worked together to develop processes and procedures for the systematic care of a stroke patient. Based on American Stroke Association clinical practice guidelines for Acute Ischemic Stroke and Recommendations from the Brain Attack Coalition for the development of a Primary Stroke Center, the LHS team has created a comprehensive program focusing on early symptom recognition and prompt treatment for acute stroke events.

15. LHS Stroke Program Mission and Vision Mission Statement – The Stroke Program at Lake Hospital System is committed to the health and well-being of patients who have experienced an Acute Stroke. Our mission is to provide comprehensive Stroke Care to the residents of Lake County and our neighboring communities in partnership with those who share a commitment to local access, healing with compassion and superior quality. Vision Statement – The Primary Stroke Center at Lake Hospital System will be recognized as a model of Stroke Care in Lake County, based on its mission, commitment to the neighbors we serve, excellence in the patient experience it provides and dedication to the education of the community in Stroke symptom recognition and prevention.

16. LHS Stroke Units 3 areas have been designated as the Stroke Units at LHS – The Emergency Departments: Usually the first point of entry in an emergency. The ED is equipped to rapidly assess the stroke patient and provide them with a clot- busting medication used in a stroke that can help reduce long term disability. – West ICU: the critical care unit designed to closely monitor a patient who has received the clot-busting medication – Step down Units at East and West: the specially trained units that are capable of caring for the post- stroke patient

17. Stroke is an Emergency Stroke is a Medical Emergency. Quick recognition of symptoms is the first step in activating the rapid evaluation and prompt treatment necessary for successful outcomes. The Stroke Center at LHS focuses on rapid evaluation and prompt treatment. The signs and symptoms of a stroke can easily be remembered by the following: – F.A.S.T Face- does one side of the face droop Arm- Does one arm drift downward Speech- is the speech slurred Time- note the time these symptoms occur Activate the Code Brain Attack Alert Call 4411- state Brain Attack room____

18. Stroke and Brain Attack post-test True or False: 1. A Stroke is an Emergency. 2. Think FAST when the Brain Attacks: Face droop, Arm drift, Speech strange, Time- call for help. 3. The number to call at LHS for an I-team and a Code Brain Attack page is 4411. 4. LHS has created a Stroke program with a focus on quick recognition and prompt emergency treatment for an acute stroke.