Who should
be transported emergently?
Time is brain! Save
the penumbra! Within the first few hours
of an ischemic stroke, brain tissue (the
penumbra) can still be saved. However, the
MEND exam alone will not determine how much
tissue can be saved. That is why it is important
to transport stroke patients to the hospital
emergently. Intervention can be administered
to a stroke patient if:
• Clinical diagnosis is confirmed by
a CT scan
• The patient is brought in within
three hours* of stroke symptom
on-set (*larger time windows of up to six
hours are available at some facilities)
• The patient is 18 years or older
(there is no upper age limit on t-PA)
• No other contraindications exist
As you are working with stroke patients
in the field, remember these guidelines
and transport these stroke patients
|
What to
remember when treating a stroke alert patient
Once you load and go, what
do you do next? Upon completion of the complete
MEND exam, the following guidelines should
be followed:
1. Avoid giving glucose
Reason: Hyperglycemia causes lactic
acidosis and damages the penumbra.
Exception: If hypoglycemic by fingerstick,
give glucose and thiamine.
2. Avoid treating hypertension
Reason: It is commonly caused by
strokes; it is required for penumbra perfusion;
it often subsides without treatment.
3. Avoid causing aspiration pneumonia
by keeping 100% NPO and elevating head 30º.
Reason: Most stroke patients have
trouble swallowing and aspiration is a major
cause of morbitity and mortality.
4. Provide O2
2-4L by nasal canula & monitor O2
saturation. |
Please contact Gretchen Castleberry if you have
any questions regarding MEND or ideas for future
newsletters at 423-265-3466
or gretchen.castleberry@heart.org.
Or info@cns.com
*All information is from the University of Miami
School
of Medicine MEND training manual.
