™
™
Stroke 101 Fact Sheet.
Journal of Emergency Medical Services
Stroke 101 Fact Sheet.
Explaining Stroke.
American Heart Association
American Heart Association
American Heart Association
Stroke 101 Fact Sheet.
Explaining Stroke.
American Heart Association
American Heart Association
F.A.S.T*
F = Facial Droop
A = Arm Drift
S = Slurred Speech or No Speech
T = Time is Important /Call 911
American Heart Association
Cincinnati Prehospital Stroke Scale*
Facial Droop
Normal: Left and Right side of face move equally
Abnormal: One side of face does not move at all
Arm Drift
Normal: Both left and right arm move together or not at all
Abnormal: One arm does not move equally with the other
Speech
Normal: Patient uses correct words with no slurring
Abnormal: Patient has slurred speech, uses inappropriate words
or cannot speak
Screening Criteria
Yes
No
1. Age over 45 years
2. No prior history of seizure disorder
3. New onset of neurological symptoms in
just 24 hours
4. Patient was ambulatory at baseline
(prior to event)
5. Blood glucose between 60 and 400
Normal
Right
Left
Facial smile/grimace
____
____Droop
____Droop
Grip
____
___Weak grip
___No grip
___Weak grip
___No grip
Arm Weakness
____
___Drifts down
___Falls rapidly
___Drifts down
___Falls rapidly
MENDS : Pre Hospital Examination*
Mental Status
Level of Consciousness (AVPU)
Speech: “You can’t teach an old dog new tricks” Questions: (Age, Month)
Commands: (Close/open eyes)
Cranial Nerves
Facial Droop: Show teeth or smile
Visual Fields: Four Quadrants
Horizontal Gaze: Side to side
Limbs
Motor: Arm Drift (close eyes hold out arms)
Leg Drift (Open eyes lift each leg separately)
Sensory: Arm, Leg (close eyes and touch, pinch)
Coordination: Arm, Leg ( finger-nose, heel-shin)
Journal of
Emergency Medical Services
Proposed Requirements for Comprehensive Stroke Center.
Journal of Neurointerventional Surgery
http://www.jems.com/article/patient-care/time-brainprehospital-stroke-treatment
Journal of Emergency Medical Services
http://circoutcomes.ahajournals.org/content/5/4/514.abstract?sid=c69e9
7af-b8b9-43dc-b7c8-e56821ee6c86
Journal of the American Heart Association
http://www.neurology.org/content/73/13/1066.abstract?sid=508da72dd140-49de-9770-02a2de0034ae
American Academy of Neurology
™
™ ™
™
Low
recanalization
rates observed
in this study*
Limitations
of IV-tPA
Time window is
from 0-3/4.5
hrs *
Recanalization
is a strong
predictor of
good
outcomes*
American Heart
Association/ American Stroke Association
™
™
™
™
™
The study
witnessed a 96%
TICI 2a-3*
™
Study witnessed
a 55% mRS< at
90 days*
American Heart Association/American Stroke Association
Median time
from groin
puncture to
revascularization
was 40 minutes*
™
positive results for life
Stroke Epidemiology
How to Assess a
Stroke Patient
The Importance of
Time and
Neurological
Outcomes
Treatment Options
for Stroke
Endovascular
Treatment for Stroke
and Solitaire™ FR
Revascularization
Device
™