Post-tPA hemorrhage in CVA

Consider bleeding if decreased LOC, increased weakness, new headache, sudden rise in blood pressure

If bleeding occurs after tPA:

1. Stop tpa infusion
2. Stat head CT
   1. if no bleeding resume tpa
   2. If bleeding check labs, consider fibrinogen replacement
3. Recheck pt/ptt, platelets, fibrinogen levels
4. Prepare 6- 8 units cryoprecipitate
5. Prepare 6- 8 units platelets

See Also

• CVA (tPA Criteria)
• CVA (Main)

Source

6/06 MISTRY