B.A.P.E.T
Brain Attack Protocol &
Emergency Treatment
By:
Nicole Florentine,
Christina Lauderman
Erin Patrick,
&
Kara Sharp
Types of Stroke

Cerebral Vascular
Accident
– Ischemic
– Clot or plaque

Transient Ischemic
Attack
– Clot or plaque causes
cerebral ischemia
causing stroke-like
symptoms
– Resolves quickly in
less than 24 hours
without intervention
– CT/MRI will be
negative
Hemorrhagic Stroke
Intracerebral
 Subarachnoid

Recognizing Common Symptoms
Speech Difficulty
 Weakness (especially one sided)
 Facial droop
 Numbness/ tingling of face or extremity

Atypical Symptoms
Dizziness
 Acute onset of blurred vision/ loss of
vision
 New onset of seizures
 Disequilibrium (balance issues)
 Confusion

Headache

ICH
– “worst
headache”
– Nausea
– Vomiting
– Generalized
weakness
– Flu-like
symptoms
– photophobia

CVA
– Headache
– One- sided
weakness
– Speech
difficulty
– Numbness
and tingling
•MIGRANE
‫“־‬band-like”,
focal
headache
‫־‬aura
‫־‬photophobia
‫־‬nausea
‫־‬vomiting
‫־‬history of
migraines
Risk Factors









Age
Gender
Race (African American)
Past CVA/ TIA
Family history
Smoking
Obesity
Heart disease
Diabetes
Alert
Purpose- Rapid Intervention of patient
with acute stroke
 Acuteness determined by CT/ MRI
 Anyone can place an alert!

ANYONE Can Place Alert!
 ANYONE can place alert by calling UPMC
Command at 412.647.5858
 If you even slightly suspect stroke
symptoms, place an alert! It can be
cancelled if determined later not to be a
stroke
 Patients have better outcomes if made an
alert!
Benchmark/ Treatment Protocol
Benchmarks need to be met to continue
our stoke accreditation
 Treatment

1.
2.
3.
4.
5.
Direct to treatment room
NIH stroke scale on arrival
MD and RN evaluation <10min
Vital Signs q5mins x3 then q15min
Blood Glucose Level
Benchmark/ Treatment Protocol
6. Labs drawn and sent within 15 minutes
7. CT scan <25minutes
8. CT read <45minutes
9. Chest X-Ray completed <45minutes
10. EKG done <45 minutes
Benchmark/ Treatment Protocol
11. NIH stroke scale needs completed to
and from testing and every 1 hour
12. TPA given less than 3hours onset of
stroke symptoms NIH/VS q15minutes
13. Angiogram <1 hour
14. Patient admitted to the floor <3hours
Benchmark/Treatment Protocol

Oral medications should NEVER be
administered to the patient until their
ability to swallow has been tested.

The nurse can perform bedside swallow
testing to evaluate for deficits
Quality Assurance
Quality assurance reviews in the
Emergency Room reveal that when all of
these benchmarks are met, patient
outcomes are significantly increased.
 American Stroke Association states “a
32.5% decline in stroke death rates
between 1999 and 2007 when stroke
protocols are followed.”

References


Miller, J. & Mink, J. (2009). Acute Ischemic Stroke: Not a
moment to lose. Nursing 2009, 39, 36-42.
Schwamm, L., Fayad, P., Acker, J., Duncan, P., Fonarow,
G, Girgus, L., Goldstein, L., Gregory, T., Kelly-Hayes, R.,
Sacco, J., Saver, J., Segrest, W., Solis, P. & Yancy, C.
(2010). Translating Evidence Into Practice: A decade of
Efforts by The American Heart Association/American
Stroke Association to Reduce Death and Disability Due to
Stroke. A Presidential Advisory From the American Heart
Association/American Stroke Association. Journal of the
American Heart Association. ISSN: 1524-4628
References
Stroke Prevention Guidelines. National Stroke
Association. Retrieved on April 18, 2010 from
http://www.stroke.org/site/PagesServer?pagena
me=PREGUIDE
 Stroke Warning Signs. American Heart
Association. Retrieved on April 18, 2010 from
http://www.americanheart.org/presenter.jhtml?i
dentifier=4742

References
UPMC Stroke Education for Patients and
Families
 UPMC Mercy Hospital Medical
Management of Stroke and Transient
Ischemic Attack Policy
 UPMC Mercy Hospital Acute Stroke and
TIA Admission Order Sets
