Long Life Study

Learn N Fun

STROKE MANAGEMENT

Posted by dokterhasan on October 1, 2009

STROKE MANAGEMENT
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.

SOURCE : HARRISON. INTERNAL MEDICINE

Advertisements

2 Responses to “STROKE MANAGEMENT”

  1. Alvardino said

    Good day!
    I would like to present my site:
    Alprazolam Alprazolam Ambien Ambien Ativan Ativan Biaxin Biaxin Carisoprodol Carisoprodol Cipro Cipro Clomid Clomid Clonazepam Clonazepam Codeine Codeine Diazepam Diazepam
    To greet!
    Bye

  2. hello,

    thanks for the great quality of your blog, every time i come here, i’m amazed.

    black hattitude.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

 
%d bloggers like this: