Table 1 Target clinical behaviours for T3 trial
Target behaviour | Target clinical behaviour (includes timepoint if not immediate) Location: emergency department | Who performs the behaviour |
|---|---|---|
Triage | All patients presenting to ED with signs and symptoms of suspected acute stroke should be triaged as Australian Triage Scale Category 1 or 2 (seen within 10Â min) | ED nurse |
Thrombolysis | All patients to be assessed for rt-PA eligibility in ED All eligible patients to receive rt-PA in ED | ED nurse, ED doctor, Stroke doctor, Stroke nurse ED doctor, Stroke doctor, Stroke nurse |
Temperature management | All patients to have their temperature taken on admission to ED and then at least 4 hourly whilst they remain in ED Temperature 37.5 °C or greater to be treated with paracetamol (acetaminophen) in ED | ED nurse ED nurse |
Blood glucose management | Venous BGL sample taken to laboratory on admission to ED Finger prick BGL recorded on admission to ED and finger prick BGL monitored every 6 h (or greater if elevated) Insulin administered to all patients with BGL > 10 mMol/L within 1 h in ED or stroke unit | ED nurse, ED doctor ED nurse, Stroke nurse ED nurse, Stroke nurse, Endocrinologist |
Swallow management | Patients to remain NBM until a swallow screen by non-Speech pathologist or swallow assessment by Speech pathologist performed in ED All patients who fail the swallow screen to remain NBM and have a swallowing assessment by a Speech pathologist whilst in ED | ED nurse, Stroke nurse, ED doctor, Speech pathologist Speech pathologist |
Transfer | All patients with stroke to be discharged from ED within 4 h All patients with stroke to be admitted to the hospital’s stroke unit | ED nurse, ED doctor, Stroke nurse, Bed manager ED nurse, Stroke nurse, Bed manager |