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

(Created page with "Consider bleeding if decreased LOC, increased weakness, new headache, sudden rise in blood pressure. If bleeding occurs after tpa given, 1- stop tpa infusion 2- stat CT- if...")
 
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Consider bleeding if decreased LOC, increased weakness, new headache, sudden rise in blood pressure.
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Consider bleeding if decreased LOC, increased weakness, new headache, sudden rise in blood pressure
  
 
   
 
   
  
If bleeding occurs after tpa given,
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If bleeding occurs after tPA:
 
 
1- stop tpa infusion
 
 
 
2- stat CT- if no bleeding, resume tpa.
 
 
 
3- check new pt/ptt, platelets, fibrinogen lvls
 
 
 
4- prepare 6- 8 units cryoprcptte
 
 
 
5- prerare 6- 8 units platelets
 
 
 
6- if ICH present on CT, check labs and consider fibrinogen replacement
 
 
 
 
 
 
CVA GENERAL
 
 
 
- asa only. Heparin not help CVA- only possible TIA
 
 
 
- control BP <185/110 with labetolol 10mg iv
 
 
 
- CT scan might be negative if hyperacute
 
 
 
- hyperglycemia worsens outcome- no glucuse in fluids and use insulin prn
 
 
 
- no ASA if TPA to be given
 
 
 
- cardiac dysrrhythmia by increased symp tone, catechol release, decreased parasymp tone.
 
  
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* Stop tpa infusion
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* Stat head CT
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* if no bleeding resume tpa
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* If bleeding check labs, consider fibrinogen replacement
 +
* Recheck pt/ptt, platelets, fibrinogen levels
 +
* Prepare 6- 8 units cryoprecipitate
 +
* Prepare 6- 8 units platelets
 
   
 
   
  

Revision as of 23:42, 1 March 2011

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


If bleeding occurs after tPA:

  • Stop tpa infusion
  • Stat head CT
  • 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


6/06 MISTRY