Difference between revisions of "Post-tPA Hemorrhage in CVA"

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Consider bleeding if decreased LOC, increased weakness, new headache, sudden rise in blood pressure
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==Background==
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*Consider if patient develops:
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**Decreased LOC
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**Increased weakness
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**New headache
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**Sudden rise in BP
  
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==Management==
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*Stop tPA
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*Head CT
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**If no bleeding: resume tPA
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**If bleeding:
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***Consider fibrinogen replacement
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***Recheck CBC, coags fibrinogen levels
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***Prepare 6-8 units cryoprecipitate
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***Prepare 6-8 units platelets
  
If bleeding occurs after tPA:
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==See Also==
# Stop tpa infusion
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*[[CVA (tPA Criteria)]]
# Stat head CT
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*[[CVA (Main)]]
## if no bleeding resume tpa
 
## If bleeding check labs, consider fibrinogen replacement
 
# Recheck pt/ptt, platelets, fibrinogen levels
 
# Prepare 6- 8 units cryoprecipitate
 
# Prepare 6- 8 units platelets
 
  
==Source==
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==References==
6/06 MISTRY
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<references/>
 
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[[Category:Neurology]]
[[Category:Heme]]
 
[[Category:Neuro]]
 

Latest revision as of 01:13, 24 July 2017

Background

  • Consider if patient develops:
    • Decreased LOC
    • Increased weakness
    • New headache
    • Sudden rise in BP

Management

  • Stop tPA
  • Head CT
    • If no bleeding: resume tPA
    • If bleeding:
      • Consider fibrinogen replacement
      • Recheck CBC, coags fibrinogen levels
      • Prepare 6-8 units cryoprecipitate
      • Prepare 6-8 units platelets

See Also

References