Progress Notes //

Stroke Critical Care note by Alexandra Dyer: Time: [XOXOXO] minutes Treatments/Evaluations: Continuous neurologic and cardiovascular monitoring for deterioration of neurologic function and complications, while obtaining immediate neurologic imaging. Considerations made for TPA and invasive therapy with discussions with family. TPA Criteria Assessment: Patient is not a TPA candidate because [XOXOXO] TPA exclusion criteria: Last known normal > 3 hours Time Onset Unknown Minimal or rapidly improving symptoms Bleeding Diathesis Ct shows > 1/3 MCA territory involvement CT shows ICH BP >185/110 even with treatment Aggressive BP therapy required i.e. Nicardipine gtt Hyper or Hypoglycemia < 50 or > 400 mg/dl Seizure at onset Stroke or Head injury < 3 months LP < 24 hours Major Surgery < 14 days Brain Tumor, AVM, Aneurysm GI/GU bleed < 21 days Arterial Puncture < 7 days Caution NIHSS > 22 For Symptoms 3-4.5 hrs Age > 80 NIHSS > 25 Any Anticoagulant Use History of CVA and DM



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