A Typical Patient's Journey: Stroke Care at DHMC

Know the warning signs

  • Sudden numbness or weakness
  • Sudden confusion, trouble speaking
  • Sudden trouble seeing
  • Sudden trouble walking, dizziness
  • Sudden severe headache
  • Call 911
  • Because Time Lost is Brain Lost

Pre-hospital care

  1. Ischemic stroke symptoms develop
  2. Ambulance called and responds
  3. Patient transported to Dartmouth Hitchcock Medical Center Emergency Department (ED)
  4. "Stroke Alert" called to notify Stroke Team to come to ED

Hospital care

Emergency Department

  1. Immediate assessment by ED staff upon arrival of the patient
  2. Stroke team arrives
  3. Initial diagnostic testing: blood test, CT scan
  4. Initial therapeutic medications administered (if indicated)

Inpatient admission

  1. Patient arrives on Stroke Unit
  2. Daily clinical care measures to prevent complications
  3. Additional diagnostic testing performed: vascular studies, MRI, ultrasound of the heart
  4. Assessment of functional impairment and rehabilitation needs
  5. Education of patient and family begins

Preparation for after-hospital care

  1. Multi-disciplinary team develops a plan with the patient and family for discharge and rehabilitation care (clinical resource coordinator, physician, nurse practitioner, nurse, social worker, rehabilitation specialists)
  2. Medication treatment is initiated to prevent another stroke and reduce other risk factors
  3. Patient goes home with in-home assistance (Visiting Nurse Association), if appropriate, or patient goes to rehabilitation or extended care facility
  4. Follow-up appointments are made in the Stroke Assessment and Prevention Clinic