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Ethos II Data Collected, Analyzed and Reported for Hospitals & National Stroke Registry

Time-to-Treatment

  • Date of Symptom Onset
  • Time of Symptom Onset
  • Time Documented by
  • Estimated Onset Time
  • Time of Arrival in ED
  • Time First Evaluated in ED
  • Time 1st Image Complete
  • Time Image Results Received in ED
  • Time tPA Given
  • No Known Onset Time
  • Onset > 24hr. Post Presentation

Patient Demographics

  • Registry Generated Patient ID #
  • Age
  • Gender
  • Ethnic Origin/Race
  • Health Insurance

Pre-hospital EMS Arrival and Transport

  • Trip Sheet available

  • Pre-hospital stroke scale recorded

  • EMS Received Call Date/Time

  • EMS Dispatch Date/Time

  • EMS 1st Patient Contact Date/Time

  • EMS Depart Scene Date/Time

Emergency Department Arrival and Diagnosis

  • Arrival Mode
  • ED Diagnosis
  • First Image Type
  • First Image Findings
  • Additional Image Findings

Stroke Team

  • Stroke Team Consulted/Activated

First Vital Signs

  • Systolic/Diastolic Blood Pressure

  • Heart Rate

  • Blood Glucose

1st Rankin Score

  • 1st Rankin Score

tPA Administered

  • Was tPA Given
  • Was Research Drug Given
  • Symptomatic Hemorrhage < 48 hours after administration
  • Life Threatening Serious Systemic Hemorrhage
  • Prior to tPA was Blood Pressure < 185/110 mmHg

NIHSS Scores

  • Baseline NIHSS Score
  • Baseline NIHSS Score Date

Reasons for Non-Treatment with Thrombolytics

  • Time
  • Uncontrolled Hypertension
  • Rapid Improvement
  • CT Findings
  • Stroke Severity - too mild
  • Stroke Severity - too severe
  • Seizure t Onset
  • Receint Surgery/Trauma(<15 days)
  • Recent IC Surgery (3 mo.) Head Trauma/Stroke
  • Patient/Family Refused
  • Consent not obtainable
  • Hx of ICH, SAH, Brain Aneurysm/tumor, AVM
  • Age
  • Active Internal Bleeding (<22 days)
  • Platelet Count (<100,000)
  • Abnormal aPTT or PT
  • Glucose < 50mg/dl or > 400mg/dl
  • No IV Access
  • Live expectancy < 1 year
  • Dementia
  • Other form of treatment
  • Other
  • Not Documented
  • Comments

Medical History

  • Stroke or TIA or VBI including Prev Hosp Date

  • Myocardial infarction (MI)

  • Coronary artery disease (CAD)

  • Atrial fibrillation

  • Heart Failure (CHF)

  • Valve prosthesis

  • Hypertension

  • Dylipidemia

  • Diabetes mellitus (DM)

  • Smoking

  • Dementia

In-hospital Diagnostic Procedures and Treatment

  • Atrial Firillation/Flutter diagnosed

  • Screening for dysphagia performed

  • Neurologist or neurosurgeon involved in care during stay

DNR Order

  • DNR Order

Carotid Stenosis Evaluation Methods Used

  • Duplex Ultrasound

  • MR Angiogram

  • CT Angiogram

  • Cerebral Angiogram

  • Transcranial Doppler

  • Carotid Stenosis Found

Stroke-related Operations/Procedures During Hospitalization

  • Aneurysm clipping

  • Aneurysm coiling/gluing

  • Craniotomy

  • Steriotactic Clot Asprtn

  • Hemicranectomy

  • Carotid Endarterectomy

  • Carotid Tenting/Angioplasty

  • Induced Hypothermia

  • Mechanical Ventilation

In-hospital Complications

  • DVT

  • Pneumonia & treatment antibiotic

  • UTI & treatment with antibiotic

  • Serious bleeding

Inpatient Anticoagulation/Antiplatelet Treatment

  • Was Sublingual Nifedipine Administered to Patient?

  • Was Anticoag/Antiplat TX Given?

Inpatient Meds Given

  • Aspirin

  • Persantine

  • Heparin IV

  • Heparin SQ

  • Ticlid

  • Aggrenox

  • Warfarin (Coumadin)

  • LMW Heparin

  • Plavix

  • Other

Antithrombotic Meds

Meds Arrived Taking

  • Aspirin

  • Aggrenox

  • Ticlid

  • Plavix

  • Persantine

  • Coumadin

  • Hep SQ

  • Hep IV

  • LMW Hep

  • Other

Meds Given at Discharge

  • Aspirin

  • Aggrenox

  • Ticlid

  • Plavix

  • Persantine

  • Coumadin

  • Hep SQ

  • Hep IV

  • LMW Hep

  • Other

Reason(s) for Non-Treatment with Antithrombotics at Discharge

  • Transferred to another facility

  • Refused Tx

  • Expired prior to discharge

  • Discharged against medical advice

  • Allergy to or complication r/t aspirin, ticlopidine, clopidogrel, dipyridamole and warfarin (hx or current)

  • Bleeding disorder

  • Risk of bleeding (current)

  • Peptic ulcer (current)

  • Terminal/comfort care on day of arrival or during stay

  • Terminal illness (life expectant less than 6 months)

  • CVA, hemorrhagic (hx or current)

  • Brain/CNS cancer (hx or current)

  • Extensive/metastatic cancer (hx or current)

  • Hemorrhage, any type (hx or current)

  • Intracranial surgery/biopsy (current)

  • Unrepaired intracranial aneurysm (hx or current)

  • Aortic dissection( current)

  • Planned surgery within 7 days following dishcharge

  • Antithrombotics (Aggrenox, asprin, dipyridamole, clopidogrel, ticlopidine) considered but not prescribed

Lipids Profile

  • HDL/LDL

  • Triglyds/Totol Cholesterol

Recurrent Stroke - Risk Reduction Interventions at Discharge

  • Smoking cessation counseling provided?

  • Discharged on diabetes medications

  • Discharged on lipid lowering medications

Counseling Received

  • Weight

  • Activity

  • Diet

  • Alcohol

Discharged on antihypertensive meds

  • Ace Inhibitors

  • Beta Blockers

  • Ca++ Chan Blockers

  • Diuretics

  • Other antihyps

  • Patient expired

  • ARB

RX for AF at Discharge

  • If AF/flutter documented, was patient on Coumadin/warfarin/heparin/heparinoid at discharge?

AF - Reasons for Non-tretment at Discharge

  • Risk of bleeding

  • Liver disease

  • Patient refused, didn't want risk

  • Patient refused, reason not given

  • Arthritis requiring NSAIDS or ASA

  • Risk for falls

  • Terminal illness

  • Discontinued due to bleeding

  • Mental status

  • No longer in AF at Discharge

  • On ASA as a regular med

  • NA - patient expired

Discharge Information

  • Length of Stay
  • Discharge Disposition
  • Outcome Rankin Score
  • When Outcome Rankin Score Evaluated
  • Principle Discharge Diagnosis
  • UB-92 Discharge Disposition
  • Rehab Location
  • Therapy Ordered

 

 

The information contained in this website is not intended to be a substitute for sound medical advice, clinical judgement or informed treatment decisions.

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