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학습 자료 둘러보기 →The highest priority in the first 24 hours after tPA is serial neurological assessment to detect hemorrhagic transformation. A subtle change in mental status or motor function is often the earliest sign of symptomatic intracranial hemorrhage (sICH).
Perform standardized checks every 15 minutes for the first 2 hours, then every 30 minutes for 6 hours, then hourly. Monitor level of consciousness, pupillary response, motor strength, and speech using a tool like the NIH Stroke Scale.
Any acute neurological deterioration, severe headache, or uncontrolled hypertension during this period is a medical emergency. Immediately stop any tPA infusion, obtain an emergent non-contrast CT scan, and notify the provider. Do not administer antiplatelets or anticoagulants.
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