Get the free Acute Stroke Services Transfer Protocol Checklist and Orders

ST. DOMINICJACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI Acute Stroke Services Transfer Protocol Checklist and Orders Date & Time 1. 2. Fax demographic sheet to: Stroke Alert Criteria: Onset of s/s

How to fill out acute stroke services transfer

How to fill out acute stroke services transfer?

1. Start by gathering all necessary patient information, including their name, age, medical history, and current condition.
2. Next, provide details about the hospital or healthcare facility where the patient is currently receiving treatment, including its name, address, and contact information.
3. Indicate the reason for the transfer, specifying that it is for acute stroke services.
4. Include the date and time of the transfer request.
5. Provide information about the accepting hospital or healthcare facility that will be providing the acute stroke services, including its name, address, and contact information.
6. Indicate any specific requirements or considerations for the transfer, such as the need for specialized equipment or personnel.
7. Specify any additional instructions or comments relevant to the acute stroke services transfer.
8. Finally, ensure that all the required signatures, approvals, and authorizations are obtained before submitting the transfer request.

Who needs acute stroke services transfer?

1. Patients who have experienced an acute stroke and require specialized treatment and care beyond what is available at their current healthcare facility.
2. Individuals who have been diagnosed with a stroke and need to be transferred to a hospital or healthcare facility with expertise in acute stroke management.
3. Patients who may have initially presented with stroke-like symptoms but are now confirmed to have had a stroke and need to be transferred for further evaluation and appropriate management.
4. Individuals who are currently receiving treatment for a stroke at a primary care center or a non-specialized hospital but would benefit from the advanced care available at a specialized stroke center.
5. Patients who have had a stroke and require immediate intervention, such as thrombolysis or endovascular treatment, which may only be available at designated stroke centers.
6. Individuals who have experienced a transient ischemic attack (TIA), also known as a mini-stroke, and need further evaluation and management to prevent future strokes.

For pdfFiller’s FAQs

What is acute stroke services transfer?

Acute stroke services transfer involves the transfer of a patient with a stroke from one medical facility to another that is better equipped to provide specialized care.

Who is required to file acute stroke services transfer?

The medical facility where the patient is initially admitted is typically responsible for filing the acute stroke services transfer.

How to fill out acute stroke services transfer?

Acute stroke services transfer forms need to be completed with all relevant patient information and medical details before submitting them to the receiving facility.

What is the purpose of acute stroke services transfer?

The purpose of acute stroke services transfer is to ensure that stroke patients receive timely and appropriate care from facilities with the necessary resources and expertise.

What information must be reported on acute stroke services transfer?

Information such as patient demographics, medical history, current symptoms, treatment provided, and any relevant test results must be included in the acute stroke services transfer.

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