SEDAN Score for Post-tPA Hemorrhage
Applies to patients not undergoing endovascular treatment, tPA within 4.5 hours.
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- Consider tPA contraindications closely, as institutions may have slightly different definitions of contraindications (absolute and relative).
- tPA for stroke should only be given in conjunction with Neurology consultation and after extensive discussion with the patient and family about risk and benefit.
- Patients receiving tPA should be monitored in an ICU setting.
- Even in low-risk patients, patients with changing neurologic exams or mental status should receive emergent re-imaging to assess for sICH.
- Consider other bleeding sites (GI, GU, for example) in post-tPA patients and exercise caution with even minimally invasive procedures such as venipuncture or foley catheter placement.