hi my name is Paul John and for today's
hippo short we're gonna go over a simple
memory tool to cover the absolute
contradict Asians to thrombolytic
administration in acute ischemic stroke
presenting within three hours now from
institution to institution the exclusion
criteria vary slightly
and so you should refer to your
institutional protocol however we're
going to be covering the 2016
eh-eh-eh-eh SI guidelines and consists
of one question followed by the letters
A through G the question is is this a
bleed like most institutional protocols
you get a non-contrast head CT to look
for the obvious intracranial hemorrhage
but don't forget suspected subarachnoid
hemorrhage is an absolute
contraindication is for AV malformation
or aneurysm or any intracranial neoplasm
for that matter
B is for blood pressure systolic greater
than 185 or diastolic greater than 110 C
is for CNS procedure or significant head
trauma or a recent stroke any of which
within the past three months
D is for diathesis that's bleeding
coagulopathy like platelets less than a
hundred thousand or inr greater than one
point seven while on warfarin or a PTT
that's elevated above normal while in
heparin or novel oral anticoagulants is
for endocarditis
whether it's confirmed or suspected
infective endocarditis F is for any
former history of intracranial
hemorrhage at any point in time and G is
for glucose less than 50 or greater than
400 and that's your memory tool for
remembering the absolute convocations to
thrombolytic administration in acute
ischemic stroke presenting within three
hours if you want more information on
this topic head on over to hippo
education com my name is Paul John I'll
see you next time
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