Download Acute stroke care : a manual from the University of by Ken Uchino PDF

By Ken Uchino

You might have simply encountered a potential stroke sufferer. You wonder, what should still I do first? How do i do know it's a stroke? Is it too past due to opposite the wear and tear? How do I do the precise issues within the correct order? This e-book might help you solution those serious questions. It presents useful suggestion at the care of stroke sufferers in a variety of acute settings. As new and potent remedies develop into on hand, and distinctive stroke facilities are created, this guidebook might help tell the healthcare pros liable for supplying care. The content material is prepared in chronological order, overlaying the issues to contemplate 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 worthwhile 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

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Small vessel: lacunar infarction. ).  Unknown: cryptogenic. SC R EENI N G F OR AR TER I AL S T ENO S IS / OBSTRUCTION MR angiography (MRA) shows arterial stenosis intracranially and extracranially, and excludes large aneurysms and vascular malformations. It is a good screening tool. 12 In our hands, carotid ultrasound is better at estimating the degree of internal carotid artery (ICA) stenosis at the bifurcation. TCD complements other vascular imaging and can also be used to follow changes over time.

Contact primary care provider for follow-up. ■ Arrange home health care if indicated. * DVT prophylaxis  Heparin 5000 units SC every 8–12 hours*, or  Enoxaparin (Lovenox, Clexane) 40 mg SC once daily or 30 mg SC every 12 hours, or  Dalteparin (Fragmin) 5000 units SC once daily;  Sequential compression devices (non-drug);  Compression (TED) stockings. Anticoagulants for cardioembolic stroke  Weight-adjusted heparin (see Appendix 7). * Insulin if needed (see Appendix 8)* Temperature control with acetaminophen if needed* HMG CoA reductase inhibitors (statins) with goal of LDL < 100* A small single-center study showed that so-called “statin withdrawal” can be harmful.

After that all patients were on atorvastatin 20 mg daily. 13 Thus, it is important to make sure patients already taking statins continue their statins even if it means placing a nasogastric tube to accomplish this. Oral antihypertensive agents*  ACE inhibitors: ■ Lisinopril (Prinivil, Zestril) 10–40 mg daily. ■ Perindopril (Aceon, Coversyl) 4 mg PO once daily. 5–5 mg daily; target 10 mg PO once daily.  Angiotensin receptor blockers (ARBs): ■ Losartan (Cozaar) 25–100 mg daily.  Diuretics: ■ Hydrochlorothiazide (HCTZ), chlorthalidone (Hygroton) 25 mg daily.

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