ACUTE STROKE: Code, Control — tPA Protocol, NIHSS & The Critical Window | Dr. Atkinson Nursing (MS2)

🧠 Every minute without perfusion results in the loss of 2 million neurons.
Acute stroke is the ultimate nursing emergency — and your speed, accuracy,
and clinical judgment in the first 5 minutes can save a brain. Dr. Atkinson
walks you through everything from TIA recognition to tPA administration to
endovascular rescue.

📋 WHAT WE COVER:
✅ Time = Brain — why urgency is the single most important concept in stroke care
✅ The 25-Minute Imaging Goal & 45-Minute Door-to-Needle Target
✅ Diagnostic Matrix — Ischemic Stroke Subtypes: Large Artery, Lacunar,
Cardioembolic, Cryptogenic
✅ Understanding TIA — the mini-stroke with a 3–15% stroke risk within 90 days
✅ Triage: The First 5 Minutes — FAST, airway alert, Code Stroke activation
✅ Cellular Ischemic Cascade — the war against time at the cellular level
✅ The Ischemic Core vs. Penumbra — what's lost vs. what's still salvageable
✅ ED Door Protocol — Minute 0, Minute 25, Minute 45 action timeline
✅ Diagnostic Toolkit — CT Non-Con, CTA, MRI/MRA, Echo & 12-Lead ECG
✅ tPA Flight Check — Inclusions (GO) vs. Exclusions (NO-GO) screening
✅ Alteplase (tPA) Protocol — dosing, delivery phases, monitoring
✅ NIH Stroke Scale (NIHSS) — scoring 0 to 42, clinical decision guidance
✅ Endovascular Rescue (Thrombectomy) — extended window up to 24 hours
✅ Post-Intervention Monitoring — hemorrhagic conversion, vitals schedule
✅ Pharmacological Management Flow — antiplatelets, anticoagulants, statins
✅ Carotid Stenosis — CEA vs. CAS comparison
✅ Comprehensive Secondary Stroke Prevention — sleep, activity, BP, diabetes

⚠️ CRITICAL ALERTS INSIDE:
- NO aspirin or anticoagulants for 24 hours post-tPA — strict ICU rule
- TIA must be treated as an acute stroke — full immediate workup required
- Time of Last Known Well is the most critical history data point
- BP must be under 185/110 for tPA eligibility — uncontrolled = exclusion
- COVID-19 alert: hypercoagulability increases ischemic stroke risk in younger patients

🎓 PERFECT FOR: MS2 nursing students, NCLEX prep, neuro & ICU clinical
rotations, new grad nurses

📌 LIKE, SAVE & SHARE — Stroke response starts before the doctor arrives.
Know what to do.

🔔 SUBSCRIBE → Dr. Atkinson Nursing | New lectures dropping regularly

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⚕️ EDUCATIONAL DISCLAIMER

The content presented in this video is intended solely for nursing school educational
and academic purposes. It is designed to support student learning in preparation for
clinical rotations, coursework, and NCLEX examination study — and does not constitute
medical advice, clinical guidance, or a substitute for professional judgment.

All information should be verified against your institution's current policies,
evidence-based clinical guidelines, and the direction of your supervising faculty
and licensed healthcare providers. Patient care decisions must always be made by
qualified, licensed professionals in accordance with applicable laws, standards
of practice, and individual patient needs.

Dr. Atkinson Nursing assumes no liability for the application of any information
contained in this content outside of an educational context.
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Видео ACUTE STROKE: Code, Control — tPA Protocol, NIHSS & The Critical Window | Dr. Atkinson Nursing (MS2) канала Dr. Atkinson Nursing