Long Life Study

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Posted by dokterhasan on October 1, 2009

1. Check and maintain vital signs. Manage patent airway, Oxygen delivery, and i.v line.

2. Get patient into Semi Fowler position with seat angle approximately 30. It purpose to maintain good venous return into jugulare vein to avoid the cerebral oedem.

3. Get the isotonic fluid (293-<320 mosmol) through the i.v line for maintain the hemodynamic. It must not be contain glucose because it can make transudation from extracellular into cerebral intracellular therefore deteriorate the cerebral oedem. KAEN 1B & 2A are the best one equall the body fluid osmolarity.

4. Treat the Risks factor. For stroke infark its recommended to treat the hypertention when BP more than 220/120 while stroke hemorraghic when BP more than 180/100. Use ACE inhibtor to treat the hypertention (captopril or diltiazem). Blood glucose is maintain within the range of 180-250 mg/dL. Trombocyte antiagregation drugs, such as aspirin 80-325 mg or others (ex, clopidogrel) should be administered.

5. In patient with consciousness disturbance, consider mannitol. Carefull for patient with decompensatio cordis. Mannitol should be administered with loading drip dose 200 cc in 20 minutes first, then drip in 100 cc every 6 hours for maintenance dose. Mannitol is given for 3-5 days and not allowed to stopped suddenly because of the rebound phenomen effect. For geriatric patient, the dose needs to lowering into 75 cc for the loading dose and respectively. Mannitol is contraindicated for patient with renal failure.



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