New CVA guidelines

[marly]

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I was told that there are some new guidelines for CVA management.

Is anyone aware of any... other than TPA if < 3 hrs, reduce BP only gradually to maintain adequate cerebral circulation.

any of you heard of such guidelines .....please shed some light.

Thanks.

 

[JayneCobb]

I was told that there are some new guidelines for CVA management.

Is anyone aware of any... other than TPA if < 3 hrs, reduce BP only gradually to maintain adequate cerebral circulation.

any of you heard of such guidelines .....please shed some light.

Thanks.

If you're looking for guidelines, go no further than this site.

But it does not appear that there are updated guidelines for thrombolysis therapy for CVA.

Clinical Highlights and Recommendations:

• Patients presenting with signs and symptoms of TIA should be evaluated for risk of immediate future events using the ABCD score.
• Patients who present in time to be candidates for treatment with tPA should be evaluated by a physician within 10 minutes, undergo a CT scan within 25 minutes of arrival in the ED, and have CT interpreted within 20 minutes of test completion.
• Intravenous tissue plasminogen activator, (tPA) if given, should be administered within three hours of stroke onset and less than 60 minutes of arrival at the ED.
• Patients presenting with stroke onset who are not candidates for intravenous tPA should promptly be given aspirin, after exclusion of hemorrhage on CT scan.
• Education regarding early stroke symptoms, risk factors, diagnostic procedures, and treatment options should be offered to the patient and family. This should be documented in the patient chart.
• Medical management for prevention of complications within the initial 24-48 hours of diagnosis and initial treatment of ischemic stroke include:
  • - continue appropriate blood pressure management;
    - continue to treat hyperthermia;
    - continue IV fluids;
    - initiate deep vein thrombosis prophylaxis;
    - perform swallow evaluation;
    - initiate early rehabilitation; and
    - perform nutritional status assessment.

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