1. Nolan, Scot MS, RN, PHN, CCRN, CNRN, CNS

Article Content

This issue of Critical Care Nursing Quarterly is devoted to the care and treatment of an often forgotten neurological emergency-inpatient stroke. Approximately 2 years ago, it was an observation that while there was a tremendous amount of national emphasis placed on the identification and care of the patient who experienced stroke as a primary diagnosis, those patients who experienced stroke as a secondary diagnosis were often underrecognized and therefore undertreated or not treated at all. In fact, much like family members of stroke patients, there was an undercurrent of denial when a patient was experiencing stroke-like symptoms while an inpatient for some other diagnosis. As a result, Code Gray was developed and implemented.


After extensive review, our team found that there was very little published on the subject of inpatient stroke. Much of that found in the literature indicated that inpatient stroke was an issue, but no discussion of protocols or strategies to care for these patients. It became increasingly clear, a year after implementation of Code Gray, that our team needed to let others know of our experience, and unique strategy. With the wise guidance of Carmen Germaine Warner, MSN, RN, FAAN, we were in contact with the editorial staff of CCNQ. We were delighted to find that our idea was overwhelmingly supported. This issue has been created through the effort of the entire Code Gray development team, and with the support of many others. Thank you does not begin to express our team's gratitude for the wonderful support of our 2 medical librarians, who tirelessly assisted each of the authors.


Although the reader may have an understanding of stroke recognition and treatment, the aim of this issue is to provide the reader with a fresh perspective on cutting edge stroke therapy. The readers will see the need to review their own in-house emergency protocols, and perhaps re-evaluate how they respond to inpatient stroke. It is our hope that the reader will find renewed hope for hospitalized patients who experience stroke, and that the critical care nurse will be encouraged to be an even stronger patient advocate when it comes to stroke as a primary or secondary diagnosis.


The goal of this issue is to provide the critical care nurse with an increased awareness of stroke as an emergency, and more specifically, to illustrate the need for a rapid, organized response to inpatient stroke. The national organizations' initiatives of "Operation Stroke," "Brain Attack," etc, are only the beginning to the next era of stroke therapy. In addition, the critical care nurse must recognize that ultimate success is not measured only by survival, but also by recovery and clinical outcome. Nursing plays a key role in providing not only early recognition, but early treatment and rehabilitation. Without these additional early interventions, our early recognition and even the emergency response of Code Gray could be in vain. It is the nurse who must recognize the patient at risk, and quickly intervene at the first sign of stroke-like symptoms.


Thank you for your attention to this issue of CCNQ. Today's patient deserves and demands the best possible care. It is the prepared nurse, who has taken the time to get educated, and then apply that knowledge to patient management, who is best equipped to provide this quality care. We believe that you will find this issue stimulating and thought provoking. Remember, stroke is an emergency!