COVID-19 has forced healthcare providers all over the world to make dramatic changes to their treatment plans, and the team at one high-volume stroke center in Canada wrote about its own experience for Stroke.
“Modifications to preexisting poststroke care protocols may be necessary during the COVID-19 pandemic to balance adequate patient safety while mitigating risk of infectious exposure while the risk of COVID-19 infection remains high,” wrote first author Laura C. Gioia, MD, MSc, University of Montreal, and colleagues. “We present a streamlined approach to facilitate poststroke monitoring in patients with stroke with unknown COVID status.”
These are five effective changes the stroke center made to provide high-quality care during these strange and unusual times:
1. Consult with applicable infections disease prevention specialists
2. Adapt to low-intensity patient monitoring.
3. Test all patients for COVID-19 immediately.
4. Transfer COVID-negative patients to the primary stroke unit and COVID-positive patients to a separate predetermined unit.
5. Delay post-stroke imaging and workup until the patient’s COVID status unless “neurological deterioration” is present.
In the initial six weeks after developing its plan, the team reported that they treated 95 patients. All but three of those patients “evolved favorably.”
“No deterioration was deemed attributable to insufficient monitoring from the lower-frequency, streamlined stroke order sets,” the authors added. “Two of the 95 patients evaluated for suspected stroke tested positive for COVID-19. These two patients were, however, diagnosed with a stroke mimic and admitted to a COVID-19 warm unit other than the one assigned to patients with stroke.”