IV tPA Thrombolysis Caution Criteria
This resource outlines the clinical scenarios requiring caution before administering IV tPA, including minor stroke symptoms, recent bleeding, advanced age, and specific comorbidity risks within the extended treatment window.
Duration
00:02:42
File size
1.51 MB
Practitioner-Guided Note
When evaluating acute stroke patients, carefully weigh relative contraindications like recent major surgery, non-compressible arterial punctures, or a history of GI/GU bleeding. In the extended 3–4.5 hour window, exercise heightened vigilance for patients over eighty-five or those presenting with severe deficits (NIHSS > 25), balancing potential functional recovery against elevated hemorrhagic risks.
Key Takeaways
Symptoms that are minor or rapidly improving may warrant withholding IV tPA.
Recent major surgery or trauma within two weeks requires a careful risk-benefit analysis.
Extended window thrombolysis requires stricter age and stroke severity screening thresholds.
Severe liver or kidney disease increases bleeding risks due to hemostatic defects