HEMISPHERE IV-RAPID STROKE
RESPONSE EXAM QUESTIONS AND
ANSWERS
EMS goal on scene - Correct Answers -15 minutes
Oxygen saturation in stroke - Correct Answers ->94%
Onset of symptoms to thrombolytics time - Correct Answers -4.5 hours
Onset of symptoms to thrombectomy time - Correct Answers -24 hours
Stroke Center designations - Correct Answers -Comprehensive Stroke Center (CSC)
Thrombectomy-capable stroke center (TSC)
Primary Stroke Center (PSC)
Acute Stroke Ready Hospital (ASRH)
Door to door transfer time - Correct Answers -<= 60 min hospital to hospital transfer
associated symptoms of stroke - Correct Answers -*especially with cerebellar and
hemorrhagic stroke
vomiting, nausea
SBP >220
stiff neck
Photophobia
Coma and decreased level of consciousness
Overlooked symptoms of stroke - Correct Answers -dizziness
headache
general weakness or fatigue
nausea, vomiting
disorientation, confusion, or memory problems
Door to doctor time - Correct Answers -ASAP - 10 min
, BP parameters - Correct Answers -do not treat elevated BP unless concurrent
myocardial infarction, heart failure, aortic dissection, or confirmed hemorrhagic stroke
Door to stroke team time (neuro expertise) - Correct Answers -ASAP - 15
Prior to thrombolytic - Correct Answers -Noncontract CT or MRI to exclude hemorrhage
Blood glucose level - to rule out hypoglycemia
BP under 180/105
When to repeat CT in Hosp to hosp transfers - Correct Answers ->60 minutes since last
CT
Baseline labs - Correct Answers -CBC, electrolytes, Renal function creatinine, troponin
and ecg to evaluate MI and arrhythmias
Coag studies if on anticoagulants
Advanced imaging if considering mechanical thrombectomy
Airway management - Correct Answers -Swallow screen should be performed on all
stroke patients
npo until complete
How long is BP elevated after stroke - Correct Answers -24-48 hrs
Increased cardiac risk with stroke - Correct Answers -Arrhythmias (including A-fib)
observed in about 25% of patients within 72 hrs of stroke
Cardiac troponin may elevate from autonomic dysfunction in acute MI/heart failure
Blood glucose and stroke - Correct Answers -Persistent hyperglycemia 24 hours
following stroke is associated with worse outcomes
Hypoglycemia can mimic stroke symptoms
Maintain glucose >60 and <180
When to raise bed 30 degrees - Correct Answers -Risk for
Aspiration
Cardiopulmonary issues
Increased intracranial pressure
Temperature and strokes - Correct Answers -Fever increases metabolic demand, which
may increase risk of brain injury
Orolingual angioedema basics - Correct Answers -can occur up to 2 hrs after
thrombolytic administration and very rarely cause airway obstruction requiring
emergency airway management
Risk for angioedema is higher in those taking ACE inhibitors and with insular or frontal
cortex strokes
RESPONSE EXAM QUESTIONS AND
ANSWERS
EMS goal on scene - Correct Answers -15 minutes
Oxygen saturation in stroke - Correct Answers ->94%
Onset of symptoms to thrombolytics time - Correct Answers -4.5 hours
Onset of symptoms to thrombectomy time - Correct Answers -24 hours
Stroke Center designations - Correct Answers -Comprehensive Stroke Center (CSC)
Thrombectomy-capable stroke center (TSC)
Primary Stroke Center (PSC)
Acute Stroke Ready Hospital (ASRH)
Door to door transfer time - Correct Answers -<= 60 min hospital to hospital transfer
associated symptoms of stroke - Correct Answers -*especially with cerebellar and
hemorrhagic stroke
vomiting, nausea
SBP >220
stiff neck
Photophobia
Coma and decreased level of consciousness
Overlooked symptoms of stroke - Correct Answers -dizziness
headache
general weakness or fatigue
nausea, vomiting
disorientation, confusion, or memory problems
Door to doctor time - Correct Answers -ASAP - 10 min
, BP parameters - Correct Answers -do not treat elevated BP unless concurrent
myocardial infarction, heart failure, aortic dissection, or confirmed hemorrhagic stroke
Door to stroke team time (neuro expertise) - Correct Answers -ASAP - 15
Prior to thrombolytic - Correct Answers -Noncontract CT or MRI to exclude hemorrhage
Blood glucose level - to rule out hypoglycemia
BP under 180/105
When to repeat CT in Hosp to hosp transfers - Correct Answers ->60 minutes since last
CT
Baseline labs - Correct Answers -CBC, electrolytes, Renal function creatinine, troponin
and ecg to evaluate MI and arrhythmias
Coag studies if on anticoagulants
Advanced imaging if considering mechanical thrombectomy
Airway management - Correct Answers -Swallow screen should be performed on all
stroke patients
npo until complete
How long is BP elevated after stroke - Correct Answers -24-48 hrs
Increased cardiac risk with stroke - Correct Answers -Arrhythmias (including A-fib)
observed in about 25% of patients within 72 hrs of stroke
Cardiac troponin may elevate from autonomic dysfunction in acute MI/heart failure
Blood glucose and stroke - Correct Answers -Persistent hyperglycemia 24 hours
following stroke is associated with worse outcomes
Hypoglycemia can mimic stroke symptoms
Maintain glucose >60 and <180
When to raise bed 30 degrees - Correct Answers -Risk for
Aspiration
Cardiopulmonary issues
Increased intracranial pressure
Temperature and strokes - Correct Answers -Fever increases metabolic demand, which
may increase risk of brain injury
Orolingual angioedema basics - Correct Answers -can occur up to 2 hrs after
thrombolytic administration and very rarely cause airway obstruction requiring
emergency airway management
Risk for angioedema is higher in those taking ACE inhibitors and with insular or frontal
cortex strokes
