Treatment occurs in a multidisciplinary setting. Nurses oversee the physical aspects of the withdrawal process, administer medications as needed and refer appropriately when other health problems are identified. Counselors run educational and motivational groups for the clients as well as meet them individually to assist with arrangement of ongoing treatment. The milieu therapist assists the nurse and counselors as needed and provides for general safety and order on the unit. Pregnant clients are all seen by a case manager who assures that they receive obstetrical care in a timely manner. All clients are seen by a nurse practitioner or physician who reviews the protocols and medical issues. There is also an admissions coordinator that keeps track of clients who are seeking treatment and books their admission as soon as a bed is available.
a Although it is desirable to know the results of these
tests before administering Activase, fibrinolytic therapy should not
be delayed while awaiting results unless: 1) there is clinical
suspicion of a bleeding abnormality or thrombocytopenia, 2) the
patient has received heparin or warfarin, or 3) the patient has
received other anticoagulants (direct thrombin inhibitors or direct
factor Xa inhibitors).
AHA=American Heart Association; AIS=acute ischemic stroke; ASA=American Stroke Association; CT=computed tomography.