Code stroke Flashcards

1
Q

manajemen pasien stroke

A
  1. BE FAST
  2. nilai NIHSS (optional)
  3. cek kriteria inklusi dan eksklusi trombolisis iv
  4. radiologi: CT scan atau MRI non kontras -> menyingkirkan ICH
  5. Lab: gula darah, profil lipid, ur, cr
  6. EKG
  7. persiapan obat: alteplase, antihipertensi iv, insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

golden hour for acute stroke

A

door to needle < 60 menit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

apa saja yg dilakukan pada saat door to needle pada pasien stroke?

A

0 min: sus stroke
<10 min: evaluasi BEFAST
<15 min: aktivasi code stroke
<25 min: CT scan/MRI
<45 min: interpretasi CT scan (aspect), lab, kriteria altaplase
<60 min: start altaplase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

apa itu BE FAST?

A

Balance
Eyes
Face
Arms
Speech
Time - onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

kriteria inklusi pemberian trombolisis (altaplase/rTPA)

A
  • > 18 tahun
  • stroke dengan defisit neurologis yang jelas
  • onset jelas <3 jam atau < 4.5 jam
  • ICH sudah tereksklusi
  • informed consent keluarga
  • ASPECTS score >6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

kapan time window pemberian altaplase iv?

A

< 3 jam atau < 4.5 jam dari onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

kriteria inklusi pemberian trombolisis (altaplase/rTPA)

A
  • > 80 tahun
  • TIA atau deficit neurologis ringan; perburukan deficit neurologis
  • ICH pada CT scan
  • riwayat trauma kepala atau stroke dalam 3 bulan terakhir
  • infark multilobar
  • kejang pada saat onset stroke
  • gejala post ictal
  • ada fraktur atau perdarahan aktif pada PF
  • riwayat operasi mayor 2 minggu terakhir
  • koagulopati
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anatomi aspect score

A

Caudate nucleus
Putamen
Internal capsule
Cortex frontal
Cortex parietal
Cortex temporal
Cortex occipital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

apa gejala dan tanda peningkatan TIK?

A
  • sakit kepala
  • penkes
  • muntah proyektil
  • papil edem
  • defisit neurologis
  • cushing triad: hipertensi, bradikardi, perubahan pola nafas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

prinsip manajemen awal TTIK?

A
  1. posisi: head up 30 derajat
  2. kontrol ventilasi => hiperventilasi
  3. mannitol
  4. penanganan simptomatik: demam, kejang, gelisah dan nyeri
  5. dexamethason (u/ edem vasogenik): 1-1.5 mg/kgbb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

dosis pemberian manitol

A

loading dose: 1gr/kgbb selama 10 - 15 menit

dosis maintenance: 0.25-0.5gr/kgbb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly