Stroke/CVA

Question 1

For ischemic CVA, door to tPA needle time?

Answer 1

< 60 min

Question 2

What is the tx for hemorrhage stroke

Answer 2

Surgical Repair

Question 3

If pt is a tPA candidate, bring BP down to XX before adm tPA

Answer 3

BP down to 185/110

Question 4

If pt is not tPA candidate, do not alter BP unless SBP > XX.

Answer 4

SBP > 220 otherwise that can cause an ischemic hypo-perfusion event

Question 5

For hemorrhage stroke, bring BP down to XX before surgery.

- What agents?

Answer 5

• BP down to goal of 160/110
• Agents: labetalol, nicardipine, and if needed nitroprusside.
• Pain killer to control HA is ok

Question 6

What is the window of opportunity for tPA

Answer 6

• 3hrs or less for most patients
• Expanded to 4.5H or less in pts:
• Younger than 80 y.o
• No anticoagulant use
• No history of previous stroke or DM

Question 7

Dose of tPA

Answer 7

• 0.9mg/kg. Max 90mg.

- Give 10% of total dose a IVB and remainder over 60min.