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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
First
Vital Signs
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
Carotid
Stenosis Evaluation Methods Used
-
Duplex Ultrasound
-
MR Angiogram
-
CT Angiogram
-
Cerebral Angiogram
-
Transcranial Doppler
-
Carotid Stenosis Found
Stroke-related
Operations/Procedures During Hospitalization
In-hospital
Complications
Inpatient
Anticoagulation/Antiplatelet Treatment
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
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
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

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