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Archive for February, 2008

Measles in Brooklyn


Measles is an acute viral illness characterized by a prodrome of fever (101o – 105oF), cough, coryza, conjunctivitis and Koplik’s spots (punctate blue-white spots on the bright red background of the buccal mucosa). The measles rash is erythematous, maculopapular and lasts 5-6 days. It usually starts on the face and proceeds down the body to involve the extremities last, including the palms and soles. The maculopapular rash is usually discrete but may become confluent on the upper body. The rash resolves in the same order that it appeared. Complications such as diarrhea, otitis media and pneumonia are frequent in young children.

Written by phil

February 26th, 2008 at 5:03 pm

Posted in ID

USE OF rTPA (Activase) IN ACUTE STROKE

rTPA (Activase) available in 100mg vials and comes with

100ml vial of its own reconstitution fluid. (1mg/ml

concentration). Activase is located in medication room PYXIS.

DOSE FOR ACUTE STROKE:

0.9mg/kg is the total dose over 60 minutes

10% of total dose is given as initial bolus.

Example: patient weighs 70 kg

Total dose is 63mg (70kg X 0.9mg)

Initial bolus is 6.3ml (10% of 63mg)

56.7ml infusion over 60 minutes

PROCEDURE:

1. Establish total dose and initial bolus

2. Reconstitute rTPA (Activase) using the prepackaged fluid.

3. Draw initial bolus from rTPA.

4. Spike the rTPA vial with IV tubing.

5. Connect to IV pump and set the remaining dose over 1 hour.

6. Perform neuro checks every 15 minutes during rTPA infusion and every 30 minutes for the next 6 hours.

See Emergency Dept. Policies for “Protocol for the Initial Evaluation and Management of Patients with Ischemic and Hemorrhagic Stroke” for indications and contraindications in the use of rTPA.

Written by phil

February 14th, 2008 at 6:55 pm

Posted in Stroke/TIA