Hemorrhagic stroke: Difference between revisions
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==Background==
==Management==
#Elevating head of bed to 30 degrees (if pt not hypotensive)
#Keep MAP <130 during acute phase
#Keep MAP <130 during acute phase
#If on coumadin with INR >1.5 consider reversal:
#If on coumadin with INR >1.5 consider reversal:

Revision as of 08:42, 28 September 2011

Background

Management

  1. Elevating head of bed to 30 degrees (if pt not hypotensive)
  2. Keep MAP <130 during acute phase
  3. If on coumadin with INR >1.5 consider reversal:
    1. Vitamin K 10mg IV gtt over 10min
      1. Small risk of anaphylaxis
      2. Takes 6-12hr to work
    2. FFP
      1. Usually need up to 6 units to bring INR to 1.2
      2. Be careful about volume overload in elderly
      3. Takes hours to work
    3. Prothrombin complex concentrate (20-50mg/kg IV x1)
      1. Fast-acting (10min) but expensive
  4. If on ASA or clopidogrel:
    1. Desmopressin (0.3mcg/kg)
    2. Platelets

See Also

SAH

Source

EMcrit Podcast 17

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