Medical:

• Medical history
• Neurological examination
• Blood tests
• Referral for CT or MRI scans
• Medication - aspirin, warfarin, thrombolysis, statins
• Detection and treatment of complications- infections,deep vein thrombosis, epileptic seizures
• Monitoring and reducing risk of further stroke. (secondary prevention)
• Communication with other hospitals, departments and with GP and primary care team

Nursing:

• General observations, alertness, effects of stroke
• Monitoring blood pressure, temperature, pulse, breathing, oxygen levels in the blood,weight
• Swallowing assessment
• Nutrition and hydration- eating and drinking
• Mouth care keeping the mouth moist and clear of food, clean teeth
• Help with feeding if needed
• Safe/therapeutic positioning in bed or chair
• Help to sit up in bed or chair, help with walking if safe to do so
• Skin care preventing pressure sores
• Help to maintain continence and going to toilet, manage catheters
• Discharge planning, liaison with community nurses, GP
• Liaison with carers and relatives

Physiotherapy:

• Assessment and treatment of muscle tone, strength and movement
• Body positioning, posture and awareness
• Balance in sitting, standing and walking
• Assessment of sensation
• Assessment and treatment of pain in arms and legs
• Care of the affected arm and leg to prevent deformity or further damage
• Provide walking aids and equipment
• Specific treatments FES (functional electrical stimulation) TENS (transcutaneous electrical nerve stimulation)
• Exercise and activity to do at home
• Referral for community physiotherapy
• Referral to Orthotist for special adapted items such as shoe raise, ankle /foot orthosis.
• Discharge planning

Occupational Therapy:

• Assessment and treatment of activities of daily living, washing, dressing, bathing, feeding, toileting
• Assessment and treatment of memory, cognition and thinking problems
• Assessment of perceptual problems, planning and sequencing
• Dexterity and hand activities
• Kitchen activities
• Scanning and visual retraining
• Home visits
• Assessment and referral for equipment and adaptations at home.
• Work related activity
• Discharge planning

Speech and Language Therapy:

• Assessment of swallowing including arranging x ray of swallow (videofluoroscopy) if required
• Assessment and treatment of speech problems
• Assessment and treatment of language problems
• Assisting carers and relatives to learn communication strategies
• Assessment and referral for equipment to aid communication
• Referral for community speech and language therapy if required

Clinical Psychology:

• Assessment and treatment of intellectual/cognitive and behavioural problems
• Advice on personal and emotional issues
• Therapy to manage change, tackle mood changes and mental health issues such as depression and anxiety
• Coping strategies to manage daily tasks and stress
• Advice to stroke team and carers for management of emotional and cognitive problems

Pharmacy:

• Advice and dispensing medicine
• Alternative medicines in liquid form for patients with swallowing difficulties.
• Supply of dispensing packs such as Dosette boxes
• Alternative caps for medicine bottles, large print labels
• Checking controlled drugs (which can only be given following strict guidelines)
• Checking and dispensing discharge prescriptions

Dietetics:

• Advice for special diets, diabetics, weight loss, weight gain, low sodium, coeliacs
• Advice for patients who require supplement or build up drinks
• Monitoring patients on alternative feeding such as PEG (feeding tube into stomach through abdomen) or Nasogastric feeds (feeding tube into stomach through nose)
• Advice on consistency of food and drinks for swallowing problems

Social Work:

• Advice and information on social or care issues
• Care needs assessments to meet the needs of the person at home
• Advice on benefits, financial assessments
• Advice on alternative care, alternative housing, supported accommodation, sheltered housing, care homes
• Advice on private home care providers
• Advice on carers needs assessment to meet the needs of carers at home
• Advocacy for patients without next of kin
• Referral for social work day care