ccs stroke - smitha09

[ArchivalUser]

if patient with stroke has come within 3 hours...........

we give tpa.
and tpa is iv and how long should we give ..........is it bolus or for 1 day..
later when to start aspirin,

here we still order
echo
doppler usg
mra /mri brain...........AM I RIGHT

IF its because of AF..........we have to control that by WARFARIN..........(CHARD SCORE...I AM NOT SURE)

any one kind person.............pls help

[ArchivalUser]

If a patient has a severe neurologic deficit caused by an acute cerebral
infarction, the immediate decision in the emergency department is
whether the patient is a candidate for thrombolytic therapy (tissue
plasminogen activator [TPA]). The initial therapeutic approach to
ischemic infarction depends greatly on the time from the onset of
symptoms to the presentation for emergency medical care. If the
onset of symptoms was less than 3 hours before the evaluation, emergent
thrombolytic therapy should be considered. If a patient awakens from
sleep with the deficit, thrombolytic therapy should not be considered
unless the duration of the deficit is clearly less than 3 hours.

[ArchivalUser]

sami.........

if he suitable canditate,,,,,,,,,,,for tpa.........how long do we give,,,,is it bolus ?
when do we start aspirin

[ArchivalUser]

0.9 mg/kg IV over 1 hour, give 10% of that as initial bolus over 1 minute; not to exceed total dose of 90 mg.....

[ArchivalUser]

thanks intensivist

[ArchivalUser]

kindly could some one comment here please.

if the symptoms are for less than 3 hrs and CT shows cerebral INFARCTION,could we give TPA(in presence of infarction).........??