Saturday, November 13, 2010

CVA Management

CVA Management protocol
below is what i could gather about CVA management:

1)Emergency CT
2)Suction of nose, mouth and pharynx if secretions present
3)Secure airway and use oropharyngeal airway tube if tongue falls back
4)Start Inj. Mannitol 150 mg iv stat in the casualty without waiting for Neurogyl to arrive.
5)Inj. Dexona 1 amp IV stat and q 8hrly (Role of dexona is controversial yet given on a no harm basis)
6)Inj. Eptoin 200mg IV stat and 100 mg IV q8hrly (If seizures present or history of seizures present )
7)Inj. Neurogyl 500mg IV bd (After admission to MICU)

8) & 9) given only if patient cannot afford neurogyl
8)Inj. Mannitol 150 mg iv q8hrly
9)Oral glycerin 30ml (6tsp/1oz) tid

10)Inj. Rantac 1 amp IV bd
11)Inj. Ampicillin 500 mg IV q8hrly ( use Inj. Taxim 1 gm IV bd if the patient is sick and toxic looking)
12)Pulse / BP / Respiration monitoring.
13)Anti hypertensive if required ( Remember BP should not go below 160/90 to maintain adequate brain perfusion, text books say that even 180/100 is ok)
14)Ryles tube feeding
15)Watch for seizures and Inj. Eptoin 200 mg iv SOS

suggestions and corrections most welcome




1 comment:

Dr Abdul Rub said...

can add strocit 500 mg IV or Aravon Inj(edravone) can be added for better outcome