Mastering Stroke Codes

TITLE: Mastering Stroke Codes
PROTOCOL: https://drive.google.com/file/d/1K9_r...

00:00 - Intro
01:43 - Activating a stroke code
02:02 - Gathering important data
02:52 - Initial stabilization
04:59 - Rapid neurological evaluation
06:48 - Addressing intracranial pressure crisis
08:01 - Basic imaging
09:31 - Review: The 7 "esses" of the stroke code
10:15 - Early management of intracranial hemorrhage
11:24 - Management of acute ischemic stroke
11:58 - Large vessel occlusion with disabling deficits
24:08 - Review
25:38 - Large vessel occlusion, non-disabling deficits
27:53 - Absent large vessel occlusion, disabling deficits
30:36 - Brief review
30:52 - Absent large vessel occlusion, non-disabling deficits
32:45 - PRACTICE
32:53 - Case 1
34:43 - Case 2
37:07 - Case 3
42:40 - Case 4

This video is intended for residents and fellows to understand the stroke code process and management of patients with acute ischemic stroke, with a specific focus on selecting patients for acute stroke interventions.

Created, produced, and narrated by:
Igor Rybinnik MD
Neurology Clerkship Director
Rutgers Robert Wood Johnson Medical School

Content experts:
Bhavika Kakadia MD,
Raymond Mirasol MD,
Deviyani Mehta MD,
Kiwon Lee MD
Division of Stroke and Neurocritical Care
Department of Neurology
Rutgers Robert Wood Johnson Medical School

Adam Ganzman, MSN, RN, APN-BC
Kimberly Hollender, MSN, RN, APN-BC
Joint Commission Certified Comprehensive Stroke Center
AHA Get With the Guidelines Stroke Gold Plus with Target: Stroke Honor Roll Elite
Robert Wood Johnson University Hospital
RWJBarnabus Health

References:
1. Huo X, ANGEL-ASPECT investigators, et al. N Engl J Med 2023; 388:1272-1283
2. Chen HS, SELECT2 investigators, et al. N Engl J Med 2023; 388:1259-1271
3. Albers GW, DEFUSE 3 investigators, et al. NEJM 2018; 378:708-718
4. Olthuis SGH, MR CLEAN-LATE investigators, et al. Lancet 2023; 401(10385):1371-80
5. Khatri P, PRISMS investigators, et al. JAMA 2018;320(2):156-166
6. Chen HS, ARAMIS investigators, et al. JAMA 2023;329(24):2135-2144
7. Kappelhof M, IRIS collaborator, et al. Presented at ISC 2023.
8. Nomani AZ, et al. Neurology 2021, 97:e2079-87.
9. Sarraj A, et al. Stroke 2021, 52(1):57-69
10. Menon BK, et al. J NeuroIntervent Surg 2019;11:1065–1069.
11. Goyal M, HERMES collaborators, et al. Lancet 2016; 387: 1723–31
12. Ma H, EXTEND Investigator, et al. NEJM 2019;380(19):1795-1803
13. Hacke W, ECASS Investigators, et al. N Engl J Med 2008; 359:1317-1329
14. Thomalla G, WAKE-UP Investigators, et al. N Engl J Med 2018; 379:611-622
15. Nouh A, et al. Stroke. 2022;53:e165–e175.
16. Berge E, et al. European Stroke Journal 2021, Vol. 6(1) I–LXII
17. Powers WJ, et al. Stroke. 2019;50:e344–e418.


Images adapted from:
Kandel ER, et al. Principles of Neural Science 5th Edition. McGraw Hill, 2012
Blumenfeld H. Neuroanatomy Through Clinical Cases, 2nd ed. Sinauer, 2010.
Adobe Creative Cloud

Music:
Hot & Cold · Haxhigeaszy

Disclaimer: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation where appropriate. Also, the opinions of the presenters do not necessarily reflect those of Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, RWJBarnabus Health, or Rutgers University as a whole.