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:
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*Consider post-tPA [[ICH]] if patient develops:
*Stop tpa infusion
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**[[AMS|Decreased LOC]]
*Stat head CT
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**Increased [[weakness]]
**If no bleeding: resume tpa
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**New [[headache]]
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**Sudden rise in [[hypertension|BP]]
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*May also have [[GI bleed]], mucosal bleeding
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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
 
**If bleeding:
 
**If bleeding:
 
***Consider fibrinogen replacement  
 
***Consider fibrinogen replacement  
***Recheck pt/ptt, platelets, fibrinogen levels
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***Recheck CBC, coags fibrinogen levels
***Prepare 6-8 units cryoprecipitate
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***Prepare 6-8 units [[cryoprecipitate]]
***Prepare 6-8 units platelets
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***Prepare 6-8 units [[platelets]]
  
 
==See Also==
 
==See Also==
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*[[CVA (Main)]]
 
*[[CVA (Main)]]
  
==Source==
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==References==
6/06 MISTRY
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<references/>
 
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[[Category:Neurology]]
[[Category:Neuro]]
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[[Category:Critical Care]]

Latest revision as of 04:30, 3 October 2019

Background

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