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Emergency Priorities in the Treatment of Cerebral Hemorrhage: Code-Intracerebral Hemorrhage
Madeleine M Puissant1, Stephan A Mayer2, Joshua N Goldstein3
1Tufts Medical School, Boston, MA, USA; Emergency Department, Maine Medical Center, MHIR-CIPHR, 321 Brackett Street, Portland, ME 04102, USA.
The focus of acute treatment of intracerebral hemorrhage (ICH) includes acute blood pressure management, prevention of secondary hematoma expansion through anticoagulation reversal, and neurosurgical interventions for select patients. Recent evidence points to ultra-early acute ICH bundles, implementing multiple therapies in parallel, as the most impactful therapy in reducing morbidity and mortality. It is time for widespread implementation of formalized care bundles in ICH, including specific metrics for time to treatment and criteria for neurosurgical therapy. No longer just "Code Stroke," it is time for "Code ICH.".
The focus of acute treatment of intracerebral hemorrhage (ICH) includes acute blood pressure management, prevention of secondary hematoma expansion through anticoagulation reversal, and neurosurgical interventions for select patients. Recent evidence points to ultra-early acute ICH bundles, implementing multiple therapies in parallel, as the most impactful therapy in reducing morbidity and mortality. It is time for widespread implementation of formalized care bundles in ICH, including specific metrics for time to treatment and criteria for neurosurgical therapy. No longer just "Code Stroke," it is time for "Code ICH.".
