SCEMSA CQI- Stroke
Q4 2019
CQI Completed By:
*
First Name
Last Name
Run Number
*
Stroke
PD#8060
Dispatched Chief complaint
Stroke/CVA
Hypoglycemia
Hyperglycemia
ALOC (Not Hypoglycemia or Seizure)
Behavioral/ Psychiatric Crisis
Breathing Problem
Sick Person
Seizure
Dizziness/ Vertigo
IFT Transfer
Chest Pain / STEMI
General Weakness
Syncope/ Near Syncope
Other
Paramedic Primary Impression
Stroke/CVA
TIA
Behavioral/ Psychiatric Crisis
ALOC (Not Hypoglycemia or Seizure)
Syncope/ Near Syncope
General Weakness
Hypoglycemia
Hyperglycemia
Seizure
Dizziness/ Vertigo
Chest Pain / STEMI
Other
Call Completed By:
*
First Name
Last Name
Suspected Stroke with one (1) new onset of lateralizing neurological signs; and/or two (2) unexplained new altered level of consciousness (Glasgow Coma Scale < 14) without response to Glucose, Glucagon or Naloxone (excluding head injury)?
Yes
No
Advanced Airway adjuncts needed?
Yes
No
Cardiac Monitoring?
Yes
No
Determined and documented Cincinnati Prehospital Stroke Scale (CPSS)?
Yes
No
Not Documented
IV attempted?
Yes
No
IV successful?
Yes
No
N/A
12 lead ECG?
Yes
No
4 lead ECG?
Yes
No
Blood glucose check?
Yes
No
N/A
Was a reliable time of day that the patient was last observed to be normal either from the patient or witness documented?
Yes
No
Did the patient wake up with symptoms?
Yes
No
Was hospital notified of "STROKE ALERT" activation?
Yes
No
Protocol Used
2101 AMA
8060 Stroke
8068 General Medical Complaint
8001 Allergic Reaction / Anaphylaxis
8007 Abdominal Pain
8015 Trauma
8017 Dystonic Reaction
8018 Overdose and/or Poison Ingestion
8020 Respiratory Distress: Airway Management
8024 Cardiac Arrhythmia
8025 Burns
8026 Respiratory Distress
8027 Nerve Agent Exposure
8028 Environmental Emergencies
8029 Hazardous Materials
8030 Discomfort/Pain of Suspected Cardiac Origin
8031 Cardiac Arrest
8038 Shock
8042 Childbirth
8044 Selective Spinal Immobilization
8061 Decreased Sensorium
8062 Behavioral Crisis/Restraint
8063 Nausea and Vomiting
8065 Hemorrhage in Trauma
8066 Pain Management
8067 Sepsis/Septic Shock
Notes:
Requires Management Review
Yes
No
Discrepancies:
Submit
Should be Empty: