Post-tPA hemorrhage in CVA: Difference between revisions
(Add MedicationDose entry for tranexamic acid)
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**STAT neurosurgery consult
**STAT neurosurgery consult
**Consider TXA 15 mg/kg IV in 250 ml x 20 min if ongoing hemorrhage after above measures
**Consider TXA 15 mg/kg IV in 250 ml x 20 min if ongoing hemorrhage after above measures
==Medication Dosing==
{{MedicationDose
| drug = Tranexamic acid
| dose = 15mg/kg IV in 250mL over 20 min
| route = IV
| context = If ongoing hemorrhage after blood products
| indication = Post-tPA Hemorrhage in CVA
| population = Adult
}}


==See Also==
==See Also==

Revision as of 21:08, 20 March 2026

Background

Management

  • Immediately Stop tPA, even on suspicion of post-tPA hemorrhage
  • STAT Head CT
  • If no bleeding: resume tPA
  • If post-tPA ICH present
    • Obtain baseline labs: CBC, D-dimer, type and screen, fibrinogen. Check INR 15 minutes after FFP administration (see below) and platelets 15 min after platelet administration (see below)
    • Administer cryoprecipitate 10 units for fibrinogen replacement
      • If fibrinogen returns > 150, discontinue, if < 150, recheck in 1 hr and if still low administer additional 20 units
    • Administer FFP 20 ml/kg
      • If INR > 1.4, give additional 20 ml/kg)
    • Administer 2-5 packs platelets
      • If platelets <100,000, give additional PRN to achieve Plt > 100,000
    • STAT neurosurgery consult
    • Consider TXA 15 mg/kg IV in 250 ml x 20 min if ongoing hemorrhage after above measures

Medication Dosing

Tranexamic acid 15mg/kg IV in 250mL over 20 min IV

See Also

References

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