E7: Urgent response

All people with suspected acute stroke are immediately transferred by ambulance to a receiving hospital providing hyper-acute stroke services. (Key: e = element | k = knowledge | s = skill)

Knowledge and understanding of…

e7k_1:
Signs and symptoms of stroke
e7k_2:
Features of less common (atypical) presentation of stroke
e7k_3:
Stroke mimics and likely presentation
e7k_4:
Stroke and TIA as medical emergencies
e7k_5:
Emergency response, investigations, interventions and treatments for stroke and TIA
e7k_6:
The timeframe for emergency investigations, interventions and treatments for stroke and TIA
e7k_7:
The anatomy and physiology of the central nervous system
e7k_8:
The physiological and neurological effects of stroke and their timeframe during and after a stroke
e7k_9:
Monitoring and acting upon physiological and neurological changes during and after a stroke
e7k_10:
How stroke can affect communication
e7k_11:
Implications of the Mental Capacity Act and how it applies to TIA
e7k_12:
Advocates for stroke and TIA patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations
e7k_13:
Complications after stroke (e.g. aspiration, airway obstruction, hypoxia, hypotension, hypertension, hyperglycaemia, bedsores), and preventing and managing them

Skills and ability to...

e7s_1:
Take and interpret thorough history, record third party information where possible, and assess mental capacity
e7s_2:
Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support
e7s_3:
Identify suspected stroke, perform screening tests (e.g. FAST) and act on results
e7s_4:
Perform basic neurological and physiological assessment (vital signs)
e7s_5:
Perform ABCDs (airways, breathing, circulation, disability), pulse oximetry and blood glucose assessment and to act on abnormal findings
e7s_6:
Identify and use methods of moving and handling the patient that are safe, depending on the individual patient or staff needs
e7s_7:
Recognise stroke-related communication problems and to adapt methods of communication
e7s_8:
Identify emergency investigations, and interventions for stroke and TIA patients available locally (Stroke Networks) and know where to take them
e7s_9:
Identify and appropriately treat stroke mimics, e.g. hypoglycaemia, epileptic seizure