Critical Matters ICU Management of Acute Ischemic Stroke
Oct 10, 2019
Dr. Sayona John, a neurointensivist and Associate Professor at Rush Medical College, shares her expertise on managing acute ischemic stroke in intensive care. She discusses critical protocols for patient assessment using the NIH Stroke Scale, emphasizes the need for careful airway and blood pressure management, and navigates the complexities of thrombolytic therapy. Dr. John also highlights the challenges of individualized patient care and the importance of interdisciplinary collaboration, while sharing insights on leadership inspired by Abraham Lincoln's presidency.
AI Snips
Chapters
Books
Transcript
Episode notes
ICU Admission Criteria for Stroke
- Admit ischemic stroke patients with large hemispheric strokes or high NIH stroke scale (>10) to the ICU for close monitoring.
- Posterior circulation strokes need airway and neurological status monitoring, often leading to intubation or surgery.
Use NIH Stroke Scale Daily
- Learn and use the NIH Stroke Scale to objectively assess stroke severity and monitor changes in neurological status.
- Use it as a communication tool with neurology and neurosurgery teams to track patient improvement or deterioration.
Early Airway Protection Key
- Intubate stroke patients with impaired consciousness or inability to protect their airway early, rather than waiting for respiratory failure.
- Avoid non-invasive ventilation in these cases as airway protection is critical.