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In This Issue:
At a moment’s notice, Kristin Lewis, BSN, RN, is ready to respond to a page for the Acute Stroke Intervention Team, report to a Tower patient care area and administer a life-saving dose of medication to a patient having a stroke.
Lewis is among many nurses from the Neuroscience ICU trained to respond to these situations throughout the Tower. For the patient, the swift response of the physician and nurse on the Acute Stroke Intervention Team can be the difference between life and death.
“The sooner the Stroke Team is called, the better it is for the patient,” said Vince Vacca, MSN, RN, CCRN, nurse educator in the Neuro ICU. “The window to treat ischemic stroke (stroke caused by a blood clot) with intravenous TPA is only three hours.”
TPA is the only FDA-approved intravenous medication effective in treating this type of stroke, but cannot be given after three hours from the onset of symptoms—making a speedy response vital.
“We have only this short window of opportunity to potentially treat stroke victims,” said Shaun Golden, BSN, RN, CNRN, nurse manager of the Neuro ICU. “Bedside nurses know their patients so very well and often are the people who get help in time.”
Just last week, the Acute Stroke Intervention Team saved the life of an elderly woman on Tower 10B. Jill Dunleavy, RN, noticed her patient having trouble breathing and called a code SART (for the STAT Anesthesia/Respiratory Therapy Team) to examine the patient. They recognized a change in neurological status causing the breathing difficulty and paged the Acute Stroke Intervention Team.
“Thanks to Jill’s attentiveness, the Acute Stroke Intervention Team was able to respond quickly and administer a life-saving dose of TPA to the patient,” Vacca said. “All nurses should be aware of their patients’ baseline neurological status. If there is a significant change, a nurse should assume it’s a stroke until proven otherwise.”
If that happens, the nurse should first call the patient’s physician. The physician will determine whether or not to page the Acute Stroke Intervention Team at beeper #31382 or by typing “Stroke Service” in the Partners Telephone Directory. The stroke MD on call will evaluate the patient and call the Neuro ICU for a nurse to bring the “clotbuster box,” which holds the TPA. Patients are then monitored in the Neuro ICU.
For more information on the Acute Stroke Intervention Team, e-mail Vacca at vvacca@partners.org