Fluids for stroke pts.

jonathan carreto

jonathan carreto

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Thoughts on fluids for stroke patients. specifically hypotensive stroke patients with possible multipule comorbidities . Articulate why or why not . Thanks
 
Intravenous fluid is a treatment for hypovolaemia, in the absence of hypovolaemia, no. It is also worth re-stating that oxygen is a treatment for hypoxaemia, not a "general tonic" for patients that are unwell and it is likely harmful in patients who have had a brain attack (stroke) therefore should be actively withheld if their SpO2 is greater than 95%
 
If hypotensive you need to treat as such. Shoot for systolic around 150 but <160. In the setting of hemorrhagic stroke slightly elevated pressures (around 150 systolic) are keeping the brain parenchyma perfused.
 
You could go by PHTLS standards and maintain a systolic of 90. You could use your own rational and aim to maintain a CPP >70.
 
teedubbyaw said:
You could go by PHTLS standards and maintain a systolic of 90. You could use your own rational and aim to maintain a CPP >70.
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And you're calculating CPP in the field how?
 
Hypotension in a patient with an active ischemic stroke is devastating and has a poor prognosis. Watershed Infarcts anyone?
 
teedubbyaw said:
I was being sarcastic. We've established I'm not good at that.
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Yeah, you're terrible at it. Pretty sure most people reading your responses just think you're a moron...
 
Fair enough... Lol
 
Teedubbyaw seems like a thinking medic a clinical medic not some cookbook medic. Look up the difference STXmedic
 
jonathan carreto said:
Teedubbyaw seems like a thinking medic a clinical medic not some cookbook medic. Look up the difference STXmedic
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Is that so? Please, kid, teach me about clinical medicine and how to not be a cookbook medic. Since he was talking about calculating CPP in the field, please enlighten me on how you're intelligent, clinically-oriented self would calculate that in the field? I can't seem to find the formula in my cookbook, so please learn me. I'll wait.
ImageUploadedByTapatalk1417818125.844155.jpg
 
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STXmedic said:
Is that so? Please, kid, teach me about clinical medicine and how to not be a cookbook medic. Since he was talking about calculating CPP in the field, please enlighten me on how you're intelligent, clinically-oriented self would calculate that in the field? I can't seem to find the formula in my cookbook, so please learn me. I'll wait. View attachment 1642
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jonathan carreto, meet STXmedic.

I used to think he was kind of a d!ck but have come to decide that he would make a great partner.

Also, I see this is your 8th post ever... Interesting tactic.
 
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Bro, I know it's hard to pick up sarcasm over the internet, but it's not THAT hard.
 
Clare: What alternative therapy to IV NSS are you using for hypotensive patients you do not judge to be volume depleted in the prehospital setting?
 
STXmedic said:
Is that so? Please, kid, teach me about clinical medicine and how to not be a cookbook medic. Since he was talking about calculating CPP in the field, please enlighten me on how you're intelligent, clinically-oriented self would calculate that in the field? I can't seem to find the formula in my cookbook, so please learn me. I'll wait. View attachment 1642
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It's MAP - ICP you idiot. :p

Haha what have I started.
 
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