Case study 27.1

What would have been the priorities for Jim on admission to hospital in relation to diagnosis and treatment?

  • Ensuring rapid diagnosis and treatment
  • Full set of observations following an A-E assessment
  • Patients with acute stroke should have a scan within an hour of arriving at hospital. The scan can be:
    • a computed tomography or CT scan, which is an x-ray of the brain to show doctors which part of the brain has been damaged, and whether the damage was caused by a clot or a bleed.
    • a magnetic resonance imaging or MRI scan, which is taken in a large tunnel-shaped scanner that uses waves to produce more detailed image of blood vessels in the brain.
    • an electrocardiogram (ECG) can show if an irregular heartbeat called atrial fibrillation may have caused your stroke. Atrial fibrillation can increase your risk of stroke, but can also be managed with medication.
  • Blood tests including cholesterol
  • If the stroke is caused by a blood clot (ischaemic stroke), the patient may be treated with a clot-busting drug to try to disperse the clot and return the blood supply to the brain.

What would have been the priorities in your care plan?

  • Food and hydration (risk of impaired swallow)
  • Mobilisation and rehabilitation, prevention of falls
  • Monitoring patient’s blood sugars regularly
  • Assistance with personal hygiene