Stroke Assessments

• MetroHealth is nationally recognized by the American Heart Association/American Stroke Association with the Gold Plus Award for quality in stroke care and the Target: STROKE list for hospitals that demonstrate consistent ability to give tPA in < 60 minutes.
• MetroHealth launched its Certified Primary Stroke Center — the first in Northeast Ohio — in 2004.
• MetroHealth became a Joint Commission certified Comprehensive Stroke Center in 2014
• Patients have access to the most advanced comprehensive stroke treatment options available 24/7 including on-site neurology and neurosurgery specialists, brain imaging scans, clot-busting medications, and advanced neuro radiology interventions.
• Highly trained and experienced staff, including physicians that are pioneers in the advancement of stroke care treatment options.
• MetroHealth's Stroke Center includes specialized inpatient stroke units as well as a dedicated CARF-accredited rehabilitation facility with a dedicated stroke unit.
• At MetroHealth, physicians are actively involved in cutting edge stroke research through numerous National Institutes of Health (NIH) and industrial trials.
• MetroHealth’s Physical Medicine & Rehabilitation physicians lead NIH researchers in studying decreased function and pain related to post-stroke weakness with Functional Electrical Stimulation (FES).
• MetroHealth is also active in developing best practices for prevention, treatment, and rehabilitation of stroke.

Guidelines for Pre-Hospital Stroke Patient Care

1. Rapidly assess patient, position patient with head at 30 degrees and protect airway, manage ABCs, and obtain vital signs.
2. Rapidly assess for deficits using a stroke scale like the Cincinnati Pre-Hospital Stroke Scale. Determine and document the time when the patient was last known to be well and onset of symptoms.
3. Check patient's blood sugar. If less than 80mg/dl, administer 50cc of 50% dextrose IV push. If greater than 400, infuse 250cc bolus of Normal Saline.
4. Obtain IV access and monitor for cardiac dysrhythmias.
5. If a possible stroke is suspected, immediately notify Med Command and receiving facility for activation of the Stroke Team.
6. Rapid/timely transport of stroke patients to a certified stroke center is key. "Load and Go" to MetroHealth.
7. MetroHealth’s Joint Commission-certified Comprehensive Stroke Center has an auto-accept policy for potential stroke victims.

Cincinnati Pre-Hospital Stroke Scale

This scale evaluates for facial palsy, arm weakness, and speech abnormalities. Items are scored as either normal or abnormal.

Resources

• American Heart Association/American Stroke Association's Get with the Guidelines
• The Joint Commission