New PDF release: Acute stroke care : a manual from the University of

By Ken Uchino

ISBN-10: 0521184843

ISBN-13: 9780521184847

You've 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? How do I do the precise issues within the correct order? This booklet can help you resolution those severe questions. It presents sensible suggestion at the care of stroke sufferers in quite a number acute settings. As new and powerful remedies turn into to be had, and particular stroke facilities are created, this guidebook may help tell the healthcare pros accountable for offering care. The content material is prepared in chronological order, masking the issues to think about in assessing and treating the sufferer within the emergency division, the stroke unit, after which on move to a rehabilitation facility. all kinds of stroke are coated. A complete set of appendices comprise helpful reference info together with dosing algorithms, conversion components and stroke scales.

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Additional info for Acute stroke care : a manual from the University of Texas-Houston Stroke Team

Example text

1). 1. Mechanisms of stroke. Source: Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. 10 Reproduced with permission. Etiological work-up for secondary prevention At the same time, we look for reversible risk factors for recurrent stroke such as hypertension, diabetes, hypercholesterolemia, and smoking/substance abuse that will need to be addressed. ), but for planning a secondary stroke prevention strategy we find the following TOAST classification11 most useful, since it is based on stroke mechanism.

1 These should be ordered in the ED, but you should not delay TPA treatment waiting for results once the patient meets established criteria (Chapter 4). AL L P A T IE NTS ■ non-contrast brain CT or brain MRI ■ blood glucose ■ serum electrolytes/renal function tests ■ ECG ■ markers of cardiac ischemia ■ complete blood count, including platelet count ‡ ■ prothrombin time/INR ‡ Recommended diagnostic evaluation ■ activated partial thromboplastin time ‡ ■ oxygen saturation ‡ Although it is desirable to know the results of these tests before giving TPA, thrombolytic therapy should not be delayed while awaiting the results unless (1) there is clinical suspicion of a bleeding abnormality or thrombocytopenia, (2) the patient has received heparin or warfarin, or (3) use of anticoagulants is not known.

N If the CT shows no blood, try to get the artery open  TPA is the only FDA-approved treatment for ischemic stroke, and you should immediately begin to determine if the patient is eligible for this therapy, and prepare for its administration. The TPA protocol is detailed in Chapter 4. 1 These should be ordered in the ED, but you should not delay TPA treatment waiting for results once the patient meets established criteria (Chapter 4). AL L P A T IE NTS ■ non-contrast brain CT or brain MRI ■ blood glucose ■ serum electrolytes/renal function tests ■ ECG ■ markers of cardiac ischemia ■ complete blood count, including platelet count ‡ ■ prothrombin time/INR ‡ Recommended diagnostic evaluation ■ activated partial thromboplastin time ‡ ■ oxygen saturation ‡ Although it is desirable to know the results of these tests before giving TPA, thrombolytic therapy should not be delayed while awaiting the results unless (1) there is clinical suspicion of a bleeding abnormality or thrombocytopenia, (2) the patient has received heparin or warfarin, or (3) use of anticoagulants is not known.

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Acute stroke care : a manual from the University of Texas-Houston Stroke Team by Ken Uchino


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