STROKE PATIENT PATHWAY

STROKE PATIENT PATHWAY

My Stroke Team Health Care Team Member Acute Stroke Unit Rehabilitation Unit Community Dietitian(s) Doctor(s) Nurse(s) Occupational Therapist(s) Psychologist(s) Physiotherapist(s) Social Worker(s) Speech Language Pathologist(s) Spiritual Care Worker(s)

TESTS MEDICATIONS TREATMENTS TRANSITION/ EMERGENCY PHASE We will assess your temperature, blood pressure, pulse, respiration, and oxygen level. We will listen to your chest We will assess your level of pain. We will do an assessment to determine the impact the stroke has had on your daily activities. We will do blood tests that can provide information about stroke risk factors and other medical problems which may be important. An Electrocardiogram (ECG) will be done. This test uses sticky pads placed on specific parts of your body to detect the electrical activity of your heart. An ECG can detect abnormal rhythms in your heart that may have caused blood clots to form. A CT Scan will be done to determine your treatment options. This test takes images of your brain using x rays and is used to identify conditions such as bleeding in your brain, stroke, and/or tumors. You may receive intravenous (IV) medications. IV medication is given through a small needle that is passed through the skin and into a vein. You will be asked about the medications that you take at home. You should not take any medication from your own supply unless notified otherwise. You may have oxygen by prongs in your nose or a mask. Difficulty swallowing is very common after a stroke and can result in the misdirection of food/fluid into the airway. For this reason, we will assess your ability to eat and drink safely before offering oral medication, food, and/or fluid. Depending on your condition, you may be restricted to bed rest while in the Emergency Room. You will be able to move in bed and get up on your own if your health care team deems it safe. If not, you will be helped. The doctor and/or health care team will explain to you what type of stroke you have had and what the plan for your care is. Feel free to ask any questions you may have. You will most likely be admitted to the Provincial Acute Stroke Unit.

TESTS MEDICATIONS TREATMENTS ACUTE PHASE We will assess your temperature, blood pressure, pulse, and oxygen level often throughout the day. We will listen to your chest. We will assess your level of pain. You will be asked about your medical history. Your health care team will do an assessment to look at any changes in your condition. We will do additional blood tests. An x ray of your chest may be done. This will alert your doctor to important problems such as pneumonia or heart failure. An Echocardiogram(ECG) may be ordered. This test uses sound waves to create a picture of your heart, and is used to determine whether your stroke was caused by a heart condition. A Carotid Doppler may be ordered. This test uses ultrasound to listen to the sound of the blood flowing through your arteries. This can help determine if plaque build up is narrowing your blood vessels and affecting the flow of blood to your brain. You will be given medications as ordered by the doctor. The medications you took at home may be changed to stabilize your condition and better manage your symptoms. You may require oxygen. If you have an IV, we will discontinue it when you are consuming enough fluid. To the best of your ability, you will participate in treatment/therapy with members of the health care team. You may still be on a special diet if you are having difficulty swallowing. The amount of food/fluid you are consuming may be monitored. If your swallowing problem is severe and/or you are unable to consume enough to meet your nutritional needs, the health care team may speak with you about alternative methods of providing food/fluid. If you are not regularly getting out of bed and moving around, you may wear special stockings to reduce the risk of blood clots. Your health care team will determine your safest activity level. Hospital routines will be explained to you. A team member will go through the Let s Talk about Stroke booklet and this document with you. Feel free to ask any questions you may have. Your readiness for discharge will be discussed with you and your caregiver(s).

TESTS MEDICATIONS TREATMENTS ACUTE PHASE Your health care team has determined to you are ready to move/transition from the acute phase of your recovery to the next phase of your care. If necessary, arrangements will be made for outpatient tests (such as follow up blood work) Your medications will be reviewed. If you have started any new medications while in hospital, you will be provided with education and prescriptions. Your health care team will refer you to any recommended outpatient services. Before going home, a Dietitian will meet with you and your caregiver(s) to review nutritional information important to your stroke/recovery. You will receive education before going home on maximizing your independence and safety in your daily activities. Your caregiver(s) have been given education and support by the team to better understand how to help you at home. If you have any questions before you are discharged, be sure to ask a team member. Additional information/resources are available through the Heart and Stroke Foundation of Prince Edward Island. (902) 892 7441 or www.heartandstroke.pe.ca You, your caregiver(s), and the health care team will work together to plan for your discharge. Your discharge plan and destination will be determined by the amount of care you require and the supports/resources that are necessary and/or available. From acute care, you may be transitioned/discharged: Home with or without extra help/supports in place To a hospital that is closer to home To a long term care facility (such as a nursing home) To a community care facility To the Provincial Rehabilitation Unit. If the health care team has determined that you would benefit from transfer to the Provincial Rehabilitation Unit (see next page), the rehabilitation team will work with you and your family to plan your discharge at a later date.

PROVINCIAL REHABILITATION UNIT Members of the rehabilitation team will introduce themselves and begin to develop your rehabilitation schedule. Rehabilitation team members will complete a variety of assessments to further examine the impact of the stroke on your daily activities. These assessments will help develop your rehabilitation plan. TESTS You may have additional blood tests. MEDICATIONS Your medications may be reviewed and changed as necessary. You may participate in three or more hours of therapy per day. TREATMENTS You will attend regularly scheduled, daily therapy sessions with a variety of team members. These sessions may take place on or off of the unit. You may still require a special diet if you are having difficulty swallowing. We may still monitor how much food/fluid you are consuming. You will receive education before going home on maximizing your independence and safety in your daily activities. Rehabilitation Unit routines will be explained to you, and you and your caregiver(s) will be given a tour of the unit. Your education will continue throughout your hospital stay. For more information about the Provincial Rehabilitation Unit, please refer to the Provincial Rehabilitation Unit Patient Handbook. Additional information/resources are available through the Heart and Stroke Foundation of Prince Edward Island. (902) 892 7441 or www.heartandstroke.pe.ca Any medication, diet, mobility, and/or personal care teaching necessary to maximize your independence and safety will be completed with you and your caregiver(s) prior to discharge. You, your caregiver(s), and the rehabilitation team will work together to plan for your discharge from hospital. Your discharge plan and destination will be determined by the amount of care you require and the supports/resources that are necessary and/or available. You may be discharged: Home with or without extra help/supports in place To a hospital that is closer to home To a long term care facility (such as a nursing home) To a community care facility Follow up appointments will be scheduled and explained to you.