Stroke och TIA
Stroke och TIA
Stroke och TIA
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Innehållsförteckning<br />
1 Terminologi ................................................................................................................................................... 1<br />
2 Prehospital vård............................................................................................................................................ 2<br />
SOS-alarm..................................................................................................................................................... 2<br />
Ambulanssjukvård ........................................................................................................................................ 2<br />
3 Sjukhusvård .................................................................................................................................................. 2<br />
Akut diagnostik............................................................................................................................................. 2<br />
Differentialdiagnostik ................................................................................................................................... 2<br />
Akut basal utredning ..................................................................................................................................... 3<br />
4 Omhändertagande av patienten i den akuta fasen (ankomstdygnet t.o.m. dygn 2) ............................... 4<br />
Behandling vid progredierande slaganfall..................................................................................................... 6<br />
5 <strong>TIA</strong> ................................................................................................................................................................. 7<br />
Akut handläggning vid <strong>TIA</strong> .......................................................................................................................... 7<br />
Differentialdiagnostik ................................................................................................................................... 7<br />
Utredning av misstänkt <strong>TIA</strong>.......................................................................................................................... 8<br />
Elektiv utredning........................................................................................................................................... 8<br />
Handläggning av patient som rapporterar genomgången <strong>TIA</strong> för mer än en vecka sedan ........................... 8<br />
6 Slaganfall ....................................................................................................................................................... 8<br />
Hjärninfarkt................................................................................................................................................... 9<br />
Cerebrala arteriter ....................................................................................................................................... 10<br />
Arteriella dissektioner................................................................................................................................. 10<br />
Andra ovanligare orsaker till hjärninfarkt................................................................................................... 11<br />
Indikationer för UCG <strong>och</strong> TEE................................................................................................................... 11<br />
Indikationer för halskärlsdoppler ................................................................................................................ 12<br />
Hjärnblödning ............................................................................................................................................. 12<br />
Waranblödning............................................................................................................................................ 12<br />
7 Sekundärprofylax ....................................................................................................................................... 13<br />
Livsstilsförändringar ................................................................................................................................... 13<br />
Farmakologisk behandling.......................................................................................................................... 14<br />
Non-kardioemboliska stroke/<strong>TIA</strong> ............................................................................................................... 15<br />
Trombocythämmare .................................................................................................................................... 15<br />
Statiner ........................................................................................................................................................ 15<br />
Extrakraniell karotissjukdom...................................................................................................................... 16<br />
Kardioemboliska stroke/<strong>TIA</strong>....................................................................................................................... 16<br />
8 Omvårdnad ................................................................................................................................................. 18<br />
Nutrition...................................................................................................................................................... 18<br />
Munhåle- <strong>och</strong> protesproblematik ................................................................................................................ 18<br />
Vattenkastning ............................................................................................................................................ 19<br />
Förstoppning ............................................................................................................................................... 19<br />
Trycksår....................................................................................................................................................... 19<br />
Trombosprofylax......................................................................................................................................... 19<br />
Personlig hygien/påklädning....................................................................................................................... 20<br />
Psykisk stimulering, social aktivering <strong>och</strong> berikande miljö........................................................................ 20<br />
9 Dysfagiutredning <strong>och</strong> behandling ............................................................................................................. 20<br />
10 Närståendes engagemang......................................................................................................................... 21<br />
11 Arbetsterapi............................................................................................................................................... 22<br />
Bedömning.................................................................................................................................................. 22<br />
Problem- <strong>och</strong> målformulering..................................................................................................................... 22<br />
Behandling .................................................................................................................................................. 22<br />
Hembesök ................................................................................................................................................... 23<br />
Utvärdering/uppföljning.............................................................................................................................. 23
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