Acute Stroke Care: A Manual from the University of Texas - by Ken Uchino

By Ken Uchino

You might have simply encountered a potential stroke sufferer. You wonder, what may still I do first? How do i do know it's a stroke? Is it too overdue to opposite the wear and tear? How do I do the precise issues within the correct order? This booklet can assist you resolution those serious questions. It presents useful recommendation at the care of stroke sufferers in a variety of acute settings. As new and powerful remedies develop into on hand, and detailed stroke facilities are created, this guidebook can help tell the healthcare execs liable for providing care. The content material is prepared in chronological order, protecting the issues to contemplate in assessing and treating the sufferer within the emergency division, the stroke unit, after which on move to a rehabilitation facility. every kind of stroke are lined. A finished set of appendices include worthy reference details together with dosing algorithms, conversion components and stroke scales.

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Additional resources for Acute Stroke Care: A Manual from the University of Texas - Houston Stroke Team

Sample text

20 WHO SHOULD BE CONSIDERED FOR IA THERAPY? Patients who have received IV TPA for a distal ICA, M1 segment of MCA, proximal M2 segment of MCA, or basilar lesion on TCD, MRA, or CTA, who have not recanalized by the time they get to the angio suite, and who still have a disabling deficit. Even if patients have received full-dose IV TPA, we have found that following IV therapy with IA therapy is safe in most patients. , before there are extensive ischemic CT changes or while the MRI still shows mismatch (see Appendix 5).

Urine pregnancy test if appropriate. Examine patient (done within the next 5 minutes). & Establish clear time of onset. , past medical history, medications). & . NIH stroke scale (Appendix 14). Obtain non-contrast head CT (maximum ED arrival to CT time should be 30 minutes). Talk to patient and family to explain risks/benefits. Obtain the patient’s weight (ask the patient or family member(s), or estimate). & If the patient weighs over 100 kg (220 lb) they will get the maximum dose and it is not important to figure out the exact weight.

P. , R. J. Adams, T. , Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. 1 Reproduced with permission from Lippincott Williams & Wilkins. 19 n n n n n n n n n n n n n n n n n n n n n n n n Ischemic stroke 20 n n n n n n n n n n n n n n n n n n n n n n n n & then consider hetastarch 250 cc IV every 8 hours. Monitor jugular venous pressure and input/output. Watch for fluid overload. Consider phenylephrine (Neo-Synephrine) drip, or other pressors, in ICU for induced hypertension.

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