Template for plan of management (ICH)
Plan:
Acute management:
- Admit to stroke unit
- Neuro-checks (q4h)
- Baseline EKG and CXR
- Basic labs: CBC,CMP, coagulation panel and troponin
- Intravenous hydration with normal saline at 75ml per hour (Avoid hypotonic fluids which worsens cerebral edema)
- Cardene drip to target SBP (100-160)
- Acetaminophen 500mg q6h prn headache
- NPO including medications until formal speech evaluation.
- Head of bed > 30 degrees for aspiration prevention and aspiration precautions ordered.
Workup:
-CTH:
-CTA:
-MRI:
-Lab work: urine drug screen
Rehabilitation:
-Stroke education and counseling
-Rehabilitation: physical therapy, occupational therapy, speech therapy consults
-Consulted social work and case management for help with discharge
Other medical issues:
HTN:
DM:
Prophylaxis: SCDs (DVT), no anti-coagulation for at least 24h given acute intra-cerebral bleed, famotidine, docusate (GI)
Patient will be staffed with the stroke attending during morning rounds.