Chaser before tPA shots?

by Andrew Summersgill, M.D.

Before taking shots of tPA, don’t forget your CHASER: a mnemonic for when NOT to give tPA in Stroke/MI patients:

  • C: Cancer
  • H: Hemorrhagic stroke in past. Hypertension>180/>110*
  • A: Aortic dissection, AV malformations
  • S: Stroke (ischemic within the last 3 months). Sugar (glucose 400mg/dL )*
  • E: Exsanguination/active bleeding
  • R: Relative contraindications

This is a quick outline to consider before pushing lytics. There is overlap between these two subsets, and obviously the list is more comprehensive, so be sure to look up the latest guidlines.

*stroke specific (ischemic, hemorrhagic, etc)

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