Neuro-Physiotherapy Stroke Care Quiz

You have a patient who you suspect or has been diagnosed with a CVA.

When should you refer to the physiotherapy team?

1 correct answer

• Within 24 hours of admission

• When you see they cannot walk

• Within 48 hours of admission

• You wait for the physiotherapist team to spot the patient themselves

Answer explanation

All patients with suspected or diagnosed CVA should be seen within 24 hours of diagnosis

Why should the medical team consider analgesia for all stroke patients?

(Could be multiple correct answers)

• If the patient reports neuropathic pain

• The physiotherapist has noted poor engagement in therapy due to pain and has asked you to review

• If musculoskeletal pain is reported

• Usually Aspirin 75mg will suffice for analgesia

Answer explanation

The vast majority of patients who have suffered a stroke will have some form of pain. Giving adequate analgesia improves the patient's ability to engage in physiotherapy, which itself over time reduces the pain they are in.

PLEASE ASK IF PATIENTS ARE IN PAIN WHEN THEY HAVE PHYSIOTHERAPY AND PRESCRIBE THEM PAINKILLERS IF THEY ARE

How can we all help the patient improve awareness of their neglected side?

(Could be multiple correct answers)

• Approach on the affected side

• Educate family to sit and stand on the affected side

• Kindly remind our colleagues to do the same

• Stand on the non-affected side.

Answer explanation

If patients are neglecting one side after a CVA it is very important to maximise the therapy opportunities to improve this AT ALL TIMES.

How do you refer to the physiotherapy team?

1 correct answer

• Fill in a form and put in the labelled referral box on your ward

• Verbally tell the physios when you see them on the ward

• Deliver the referral form to the physiotherapy department.

• Write 'physio' in the plan section on the patient's notes.

Answer explanation

Having one process is key.

There have been numerous miscommunication incidents following informal verbal requests to review patients, which delays treatment and harms the patient.

Please place forms IN THE BOXES

A patient is struggling with their swallow. What do you suggest?

(Could be multiple correct answers)

• Thicker fluids where possible.

• Small sips

• Close mouth to elicit swallow

• Don't suggest anything and risk aspiration.

Answer explanation

Suggest drinks with a smoothie or milkshake consistency in absence of fluid thickener.

Educating the family and patient is vital to ensure they engage with our advice.

What is wrong with this picture?

(1 correct answer)

• The patient is slumped in his chair

• His affected limb is not supported

• He is looking to his neglected side

Answer explanation

Taking the time to educate the family and remind our colleagues how to care/handle the upper limb will reduce pain and improve function.