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

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*Consider if decreased LOC, increased weakness, new headache, sudden rise in blood pressure
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==Background==
*If bleeding occurs after tPA:
+
#Consider if pt develops:
*Stop tpa infusion
+
##Decreased LOC
*Stat head CT
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##Increased weakness
**If no bleeding: resume tpa
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##New headache
**If bleeding:
+
##Sudden rise in BP
***Consider fibrinogen replacement  
+
 
***Recheck pt/ptt, platelets, fibrinogen levels
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==Management==
***Prepare 6-8 units cryoprecipitate
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#Stop tPA
***Prepare 6-8 units platelets
+
#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==
 
==See Also==

Revision as of 08:32, 28 September 2011

Background

  1. Consider if pt develops:
    1. Decreased LOC
    2. Increased weakness
    3. New headache
    4. Sudden rise in BP

Management

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

See Also

Source

6/06 MISTRY