ED Clinical Pathway for Stroke Management
- Transport RN:
- Triage symptoms for possible stroke
- Call Stroke Pager & link referring
- MD to Stroke Service Provider while on transport line
- Connect stroke service responder to either ED-MCP or PICU admit fellow to coordinate care
- If concern for stroke:
- Ensure outside hospital has uploaded images
- Direct stroke consultant to contact Neuroradiology
- Stroke Team (xTend): 75842
- Further care, Neurology consult as clinically indicated
- Obtain imaging per discussion with Stroke Team with CT or MRI
- Imaging per ED/Neurology Discussion
- Continue neuroprotective intervention
- Discuss further care with Stroke Team
- Special cases
- Initial Treatment Guidelines
- Normal CT or MRI
- Reassess symptoms
- Discuss disposition with Stroke Team
discharge to home
- Stroke Screening Questions
- Is there a focal neurologic deficit?
- Unilateral weakness or sensory change
- Vision loss, double vision
- Speech difficulty
- Dizziness or trouble walking
- New onset seizures with focal findings
- Did the problem begin or get worse suddenly?
- What was the time of symptom onset?
- When was child last seen symptom free?
- When did the child last eat or drink?
- Does the child have dental hardware?
Posted: September 2007
Revised: October 2011, October 2017, October 2019 (Reviewed)
Authors: R. Ichord; MD, J. Lavelle, MD; R. Rempell, MD; N. Tsarouhas, MD; C. Jacobstein, MD; MK Abbadessa, RN; J. Baren, MD; L. Fahringer, RN;
- Guidelines for Urgent Management of Stroke in Children
- Management of Stroke in Infants and Children - AHA Scientific Statement
- Evaluating Stroke in Children Video
- American Stroke Association
- the INTERNET Stroke Center
- National Institute of Neurologic Disorders and Stroke
- National Stroke Association
Related CHOP Program