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

  • Ischemic stroke symptoms develop
  • Ambulance called and responds
  • Patient transported to Dartmouth-Hitchcock Emergency Department (ED)
  • "Stroke Alert" called to notify Stroke Team to come to ED

Hospital care at Dartmouth-Hitchcock

Emergency Department

  • Immediate assessment by ED staff upon arrival of the patient
  • Stroke Team arrives
  • Initial diagnostic testing: Blood test, CT scan
  • Initial therapeutic medications administered (if indicated)

Inpatient admission

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

Preparation for after-hospital care

  • 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)
  • Medication treatment is initiated to prevent another stroke and reduce other risk factors
  • Patient goes home with in-home assistance (Visiting Nurse Association), if appropriate, or patient goes to rehabilitation or extended care facility
  • Follow-up appointments are made in the Stroke Assessment and Prevention Clinic