Acute Stroke And Brain Injury Flashcards
What is the first step when a stroke is suspected?
Determine type of stroke, ischemic or hemorrhagic (CT scan)
Who is eligible to take tPA in an ischemic stroke?
If it is within 3-4 hours after stroke
What is tPA?
Clot busting medication for ischemic strokes
Why can you not mobilize after taking tPA for 24 hours?
Concerns of bleeding
What is treatment for ischemic stroke if you are past the tPA window?
Platelet anti aggregants/anti-coagulants
Endovascular intervention (catheter withdrawal)
What are some managements needed in an ischemic stroke?
Treatment for fever
BP management
Continuation of statins
What are the acute managements of hemorrhagic stroke?
Control bleeding (surgical intervention)
Reduce pressure (medication or surgery)
Supportive care (small bleeding)
What is acute management of TBI?
Establish GCS
Prevent increased ICP
Seizure prevention
What can result in increased ICP?
Edema, abnormal fluid dynamics, or hematomas
What is the normal ICP?
7-17 mmHg
What can a severe increase of ICP by 25-30 mmHg result in?
Brain herniation
What are the medications used to treat increasing ICP?
Pentobarbitol and pavulon
Pentobarbitol
Acts on smooth and skeletal muscles (careful monitoring of cardio respiratory status)
Pavulon
Blocks impulse at NMJ (affects skeletal muscles only)
How does ventriculostomy treat increasing ICP?
Open to drain
