Download e-book for kindle: Acute stroke care : a manual from the University of by Ken Uchino
By Ken Uchino
You will have simply encountered a potential stroke sufferer. You wonder, what should 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 suitable issues within the correct order? This ebook may also help you resolution those severe questions. It offers useful suggestion at the care of stroke sufferers in a variety of acute settings. As new and potent remedies turn into on hand, and precise stroke facilities are created, this guidebook may help tell the healthcare pros accountable for supplying 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 coated. A accomplished set of appendices include valuable reference info together with dosing algorithms, conversion elements and stroke scales.
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Extra resources for Acute stroke care : a manual from the University of Texas-Houston Stroke Team
Consider hetastarch (Hespan, Hextend) for volume expansion: ■ hetastarch 500 mL over 1 hour. AN T I P L A T E L E T A N D AN T I C O A GU L A N T T H E R A P Y AS A N A C UTE T RE ATM E NT F OR I S CH E MI C S TR OK E Both antiplatelet and anticoagulant therapy are often considered in the acute therapy of ischemic stroke, and one or both may be appropriate, but randomized trials have shown that anticoagulants should not be routinely employed acutely. Trials have shown that antiplatelets have only a modest beneﬁt, and no studies have yet shown the beneﬁt of urgent antiplatelet treatment.
Foley catheter (optional). Door to needle time: goal is < 40 minutes, maximum is 60 minutes. 9 mg/kg up to a maximum of 90 mg total. 10% given as IV bolus over 1 minute. Remaining 90% infused over 1 hour. Note: Only TPA has been approved for the treatment of stroke. Other drugs that may be given to patients with MI may not be used for stroke. These include reteplase (Retavase), tenecteplase (TNKase, Metalyse), streptokinase (Streptase). Make sure to double-check the name of the drug because there are some hospitals that may not carry TPA.
Coagulation studies (PTT, INR) if patient is on anticoagulants or coagulopathy is suspected. , ED point-of-care equipment), but we have found this method to be insufﬁciently accurate. ■ 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.
Acute stroke care : a manual from the University of Texas-Houston Stroke Team by Ken Uchino