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Protected Code Stroke: Hyperacute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic.
Khosravani, Houman; Rajendram, Phavalan; Notario, Lowyl; Chapman, Martin G; Menon, Bijoy K.
  • Khosravani H; From the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Canada (H.K., P.R.).
  • Rajendram P; From the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Canada (H.K., P.R.).
  • Notario L; School of Nursing, McMaster University, Hamilton, Canada (L.N.).
  • Chapman MG; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada (M.G.C.).
  • Menon BK; Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Cumming School of Medicine and the Hotchkiss Brain Institute, University of Calgary, Canada (B.K.M.).
Stroke ; 51(6): 1891-1895, 2020 06.
Article in English | MEDLINE | ID: covidwho-26794
Semantic information from SemMedBD (by NLM)
1. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
2. Ability PREDISPOSES Communicable Diseases
Subject
Ability
Predicate
PREDISPOSES
Object
Communicable Diseases
3. Recovery of Function COEXISTS_WITH Neurologic Symptoms
Subject
Recovery of Function
Predicate
COEXISTS_WITH
Object
Neurologic Symptoms
4. Performance PROCESS_OF Homo sapiens
Subject
Performance
Predicate
PROCESS_OF
Object
Homo sapiens
5. Consideration COEXISTS_WITH Cerebrovascular accident
Subject
Consideration
Predicate
COEXISTS_WITH
Object
Cerebrovascular accident
6. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
7. Ability PREDISPOSES Communicable Diseases
Subject
Ability
Predicate
PREDISPOSES
Object
Communicable Diseases
8. Recovery of Function COEXISTS_WITH Neurologic Symptoms
Subject
Recovery of Function
Predicate
COEXISTS_WITH
Object
Neurologic Symptoms
9. Performance PROCESS_OF Homo sapiens
Subject
Performance
Predicate
PROCESS_OF
Object
Homo sapiens
10. Consideration COEXISTS_WITH Cerebrovascular accident
Subject
Consideration
Predicate
COEXISTS_WITH
Object
Cerebrovascular accident
ABSTRACT
Background and Purpose- Hyperacute assessment and management of patients with stroke, termed code stroke, is a time-sensitive and high-stakes clinical scenario. In the context of the current coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus, the ability to deliver timely and efficacious care must be balanced with the risk of infectious exposure to the clinical team. Furthermore, rapid and effective stroke care remains paramount to achieve maximal functional recovery for those needing admission and to triage care appropriately for those who may be presenting with neurological symptoms but have an alternative diagnosis. Methods- Available resources, COVID-19-specific infection prevention and control recommendations, and expert consensus were used to identify clinical screening criteria for patients and provide the required nuanced considerations for the healthcare team, thereby modifying the conventional code stroke processes to achieve a protected designation. Results- A protected code stroke algorithm was developed. Features specific to prenotification and clinical status of the patient were used to define precode screening. These include primary infectious symptoms, clinical, and examination features. A focused framework was then developed with regard to a protected code stroke. We outline the specifics of personal protective equipment use and considerations thereof including aspects of crisis resource management impacting team role designation and human performance factors during a protected code stroke. Conclusions- We introduce the concept of a protected code stroke during a pandemic, as in the case of COVID-19, and provide a framework for key considerations including screening, personal protective equipment, and crisis resource management. These considerations and suggested algorithms can be utilized and adapted for local practice.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Triage / Coronavirus Infections / Stroke / Pandemics Subject: Pneumonia, Viral / Triage / Coronavirus Infections / Stroke / Pandemics Type of study: Observational study / Prognostic study Language: English Journal: Stroke Clinical aspect: Diagnosis / Etiology Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Triage / Coronavirus Infections / Stroke / Pandemics Subject: Pneumonia, Viral / Triage / Coronavirus Infections / Stroke / Pandemics Type of study: Observational study / Prognostic study Language: English Journal: Stroke Clinical aspect: Diagnosis / Etiology Year: 2020
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