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23 Cards in this Set
- Front
- Back
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Risk factors for ICH |
Hypertension cerebral amyloid angiopathy cocaine use low cholesterol oral anticoagulant use excessive ETOH abuse |
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What is the significance of an irregularly shaped ICH? |
Greater hematoma growth, probably indicates that bleeding occurred from multiple arterioles |
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Dose of FFP for warfarin reversal |
15 mL/Kg, usually 4-6 units (200mL) each) |
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What is the dose of protamine sulfate for UFH and LMWH reversal? |
1mg per 100 units of heparin 1mg per 1mg of enoxaparin |
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What is the dose of DDAVP for platelet dysfunction? |
0.3 ug/Kg |
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FAST Trial recommendations? |
Routine rFVIIa fro ICH within 4 hours time window cannot be recommended |
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Preferred induction agents for RSI in neuro patients |
Propofol and etomidate *short-acting and do not obscure neuro examination for prolonged period of time |
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Precautions in the use of succinylcholine |
Avoid in renal disease - can cause life-threatening hyperkalemia Causes theoretical ICP elevation in patients with intracranial mass lesions |
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Preferred neuromuscular blocking agents in neuro patients |
Cis-atracurium (esp in renal patients) Rocuronium Vecronium |
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Results of INTERACT trial |
Early intensive BP reduction attenuated hematoma expansion in patients with ICH |
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When should you consider EVD insertion in patients with ICH? |
GCS 8 or less Signs of acute HCP or intracranial mass effect on CT Prognosis that warrants ICU care |
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MOA of labetalol? |
Alpha1, beta1, beta2 receptor blocker |
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MOA of labetalol? |
Alpha1, beta1, beta2 receptor blocker |
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MOA of esmolol |
B1 antagonist |
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MOA of fenoldepam |
Dopamine 1 receptor agonist |
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Precautions when using labetalol and esmolol |
bradycardia CHF Bronchospasm |
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How to dose 23.4% saline solution? |
0.5 to 2.0 mL/Kg |
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How to dose 23.4% saline solution? |
0.5 to 2.0 mL/Kg |
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Results of the STICH study? |
1000 ICH patients, emergent evacuation within 72 hours vs initial medical management - surgery does not improve outcome (except for the subgroup with superficial hematomas and no IVH) |
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This type of ICH may benefit from emergent surgical evacuation |
Cerebellar hemorrhage >3cm diameter |
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Clear trial tPA protocol |
1mg tPA q8h (EVD claimed x 1 hour) until clearance of blood from III ventricle |
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Clear trial tPA protocol |
1mg tPA q8h (EVD claimed x 1 hour) until clearance of blood from III ventricle |
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When can anticoagulation be restarted in patients with ICH? |
In patients with strong indications (mech heart valve, AF with h/o embolic stroke), anticoagulation can be safely implemented after 10 days. |
