To be a Competent Nurse

To be a Competent Nurse Clinical nursing education focused on skills, safety, and competencies.

๐Ÿšจ Emergency Caseู…ุฑูŠุถ ูŠุจู„ุบ ู…ู† ุงู„ุนู…ุฑ 70 ุนุงู…ู‹ุง ูˆุตู„ ุฅู„ู‰ ู‚ุณู… ุงู„ุทูˆุงุฑุฆ ูŠุนุงู†ูŠ ู…ู†:๐Ÿง  ุถุนู ู…ูุงุฌุฆ ููŠ ุงู„ุฌุงู†ุจ ุงู„ุฃูŠู…ู† ู…ู† ุงู„ุฌุณู…๐Ÿ—ฃ ุตุนูˆุจุฉ ููŠ...
11/03/2026

๐Ÿšจ Emergency Case
ู…ุฑูŠุถ ูŠุจู„ุบ ู…ู† ุงู„ุนู…ุฑ 70 ุนุงู…ู‹ุง ูˆุตู„ ุฅู„ู‰ ู‚ุณู… ุงู„ุทูˆุงุฑุฆ ูŠุนุงู†ูŠ ู…ู†:
๐Ÿง  ุถุนู ู…ูุงุฌุฆ ููŠ ุงู„ุฌุงู†ุจ ุงู„ุฃูŠู…ู† ู…ู† ุงู„ุฌุณู…
๐Ÿ—ฃ ุตุนูˆุจุฉ ููŠ ุงู„ูƒู„ุงู…
๐Ÿ‘ ุงู†ุญุฑุงู ููŠ ุญุฑูƒุฉ ุงู„ุนูŠู†
ุชู… ุนู…ู„ CT Brain ุจุดูƒู„ ุนุงุฌู„.
๐Ÿ“„ ุงู„ู†ุชูŠุฌุฉ No Intracranial Hemorrhage
ุงู„ุณุคุงู„ ุงู„ุขู† ๐Ÿ‘‡
โ“ ูƒูŠู ู†ู‚ูŠู… ุดุฏุฉ ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ ุจุณุฑุนุฉุŸ
ุงู„ุฅุฌุงุจุฉ:
๐Ÿง  NIH Stroke Scale (NIHSS) (National Institutes of Health Stroke Scale)
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿง  What is NIHSS?
NIH Stroke Scale (NIHSS)
ุชุนุงู„ูŠ ุงู‚ูˆู„ูƒ ู‡ูˆ ู…ู‚ูŠุงุณ ุจูŠุชู… ุงุณุชุฎุฏุงู…ู‡ ู„ุชู‚ูŠูŠู… ุดุฏุฉ ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ ุจุณุฑุนุฉ ูˆุฏู‚ุฉ ููŠ ุงู„ุทูˆุงุฑุฆ ูˆูˆุญุฏุงุช ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ.
ูŠุณุงุนุฏ ุงู„ูุฑูŠู‚ ุงู„ุทุจูŠ ููŠ:
โœ”๏ธ ุชุญุฏูŠุฏ ุดุฏุฉ ุงู„ู€ Stroke
โœ”๏ธ ุงุชุฎุงุฐ ู‚ุฑุงุฑ ุฅุนุทุงุก Thrombolytic therapy (tPA / TNK)
โœ”๏ธ ู…ุชุงุจุนุฉ ุงู„ุชุบูŠุฑุงุช ุงู„ุนุตุจูŠุฉ ู„ู„ู…ุฑูŠุถ
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿ“Š NIHSS Components
ุจูŠุชูƒูˆู† ู…ู† 11 ุนู†ุตุฑ ุงุณุงุณูŠ ูˆู‡ู…:
โ˜‘๏ธLevel of consciousness

โ˜‘๏ธOrientation questions

โ˜‘๏ธGaze deviation

โ˜‘๏ธVisual fields

โ˜‘๏ธFacial palsy

โ˜‘๏ธMotor arm

โ˜‘๏ธMotor leg

โ˜‘๏ธLimb ataxia

โ˜‘๏ธSensory

โ˜‘๏ธLanguage (Aphasia)

โ˜‘๏ธExtinction / Neglect

ูƒู„ ุนู†ุตุฑ ูŠุชู… ุชู‚ูŠูŠู…ู‡ ุจุฏุฑุฌุฉ ู…ุญุฏุฏุฉุŒ ูˆูŠุชู… ุฌู…ุน ุงู„ู†ู‚ุงุท ู„ู„ุญุตูˆู„ ุนู„ู‰ ุงู„ุฏุฑุฌุฉ ุงู„ู†ู‡ุงุฆูŠุฉ.
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿ“ˆ NIHSS Interpretation
๐Ÿ”น 0 โ†’ No neurological deficit
๐Ÿ”น 1 โ€“ 4 โ†’ Minor stroke
๐Ÿ”น 5 โ€“ 15 โ†’ Moderate stroke
๐Ÿ”น 16 โ€“ 20 โ†’ Moderate to severe stroke
๐Ÿ”น 21 โ€“ 42 โ†’ Severe stroke
๐Ÿ“Œ ูƒู„ู…ุง ุงุฑุชูุนุช ุงู„ุฏุฑุฌุฉุŒ ุฒุงุฏุช ุดุฏุฉ ุงู„ุฅุตุงุจุฉ ุงู„ุนุตุจูŠุฉ.
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿ‘จโ€โš•๏ธ Nursing Role in NIHSS

๐Ÿ”ตNurses play a critical role in stroke assessment.

๐ŸŸคKey responsibilities include:

โœ”๏ธ Perform the initial neurological assessment using NIHSS
โœ”๏ธ Monitor changes in neurological status
โœ”๏ธ Detect early signs of neurological deterioration
โœ”๏ธ Communicate abnormal findings to the medical team
โœ”๏ธ Reassess the patient to evaluate treatment response
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿ“Œ Save this post for quick revision
ู„ูˆ ุนุฌุจูƒ ุงู„ุจูˆุณุช ู…ู…ูƒู† ุชุนู…ู„ ุดูŠุฑ ุนุดุงู† ูŠูˆุตู„ ู„ุบูŠุฑูƒ
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”






๐Ÿšจ Emergency Caseู…ุฑูŠุถ 65 ุณู†ุฉ ูˆุตู„ ู„ู„ุทูˆุงุฑุฆ ูŠุนุงู†ูŠ ู…ู†:๐Ÿง  ุถุนู ู…ูุงุฌุฆ ููŠ ุงู„ุฌุงู†ุจ ุงู„ุฃูŠู…ู†๐Ÿ—ฃ ุตุนูˆุจุฉ ููŠ ุงู„ูƒู„ุงู…โฑ ุจุฏุงูŠุฉ ุงู„ุฃุนุฑุงุถ ู…ู†ุฐ ุณุงุนุชูŠู†...
06/03/2026

๐Ÿšจ Emergency Case

ู…ุฑูŠุถ 65 ุณู†ุฉ ูˆุตู„ ู„ู„ุทูˆุงุฑุฆ ูŠุนุงู†ูŠ ู…ู†:
๐Ÿง  ุถุนู ู…ูุงุฌุฆ ููŠ ุงู„ุฌุงู†ุจ ุงู„ุฃูŠู…ู†
๐Ÿ—ฃ ุตุนูˆุจุฉ ููŠ ุงู„ูƒู„ุงู…
โฑ ุจุฏุงูŠุฉ ุงู„ุฃุนุฑุงุถ ู…ู†ุฐ ุณุงุนุชูŠู†
ุชู… ุนู…ู„ CT Brain/No hemorrhage

ุถุบุท ุงู„ุฏู… 170 / 100 :
ุงู„ุณุคุงู„ ู‡ู†ุง ๐Ÿ‘‡
ู‡ู„ ู†ุนุทูŠ ู„ู„ู…ุฑูŠุถ Thrombolytics ูˆู„ุง ู„ุงุŸ ูˆู‡ู†ุง ู†ู‚ุตุฏ ุงู„ TPA & TNK
ุฎู„ูŠู†ุง ู†ูู‡ู… ุงู„ู…ูˆุถูˆุน ๐Ÿ‘‡
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿง  TPA (Alteplase)
๐ŸŸฃTissue Plasminogen Activator (TPA)

๐ŸŸกุงูŠู‡ ุงู„ TPA ุฏู‡ ุŸ

TPAโœ”๏ธ ู‡ูˆ ุฅู†ุฒูŠู… ุทุจูŠุนูŠ ู…ูˆุฌูˆุฏ ููŠ ุงู„ุฌุณู…ุŒ ูˆTPA ุงู„ุฏูˆุงุฆูŠ ู‡ูˆ ู†ุณุฎุฉ ุตู†ุงุนูŠุฉ ู…ู†ู‡. ูˆุธูŠูุชู‡ ุงู„ุฃุณุงุณูŠุฉ ู‡ูŠ ุชุญูˆูŠู„ ุงู„ู€ plasminogen ุงู„ู…ูˆุฌูˆุฏ ููŠ ุงู„ุฏู… ุฅู„ู‰ ุงู„ู€ plasmin ุทูŠุจ ุงู„ Plasmin ุฏู‡ ุจูŠุนู…ู„ ุงูŠู‡ ุจูŠุฑูˆุญ ูŠุนู…ู„ break down ู„ู„ fibrin ุงู„ู„ูŠ ู‡ูˆ ุงุตู„ุง ุนุจุงุฑู‡ ุนู† ุจุฑูˆุชูŠู† ู…ุณุคู„ ุนู† ุชูƒูˆูŠู† ุงู„ุฌู„ุทุงุช ููƒุฏู‡ ุนู…ู„ dissolve for blood clot ูˆุงู„ุนู…ู„ูŠู‡ ุฏู‡ ุงุณู…ู‡ุง fibrinolysis

ุทูŠุจ ุงูŠ ู‡ูŠ ุงุณุชุฎุฏู…ุงุชู‡ ุŸ ๐ŸŸก

โœ”๏ธAcute Myocardial Infarction (MI)
โœ”๏ธIschemic Stroke
โœ”๏ธMassive Pulmonary Embolism (PE)
โœ”๏ธDeep Vein Thrombosis (DVT
โœ”๏ธPeripheral Arterial Thrombosis & Occluded catheters

๐ŸŸกุทูŠุจ ุฏู‡ ุญู„ูˆ ุฌุฏุง ูˆู‡ูŠุญู„ู†ุง ู…ุดุงูƒู„ ูƒุชูŠุฑ ู„ุง ุงุณุชู†ูŠ ุฏู‡ ู„ูŠู‡ criteria ู…ุนูŠู†ู‡ ุนุดุงู† ูŠู†ูุน ูŠุชุงุฎุฏ ู„ู„ู…ุฑูŠุถ ูˆู„ูŠู‡ ุดูˆูŠู‡ complication ู…ู…ูƒู† ุชุญุตู„ ุจุณุจุจู‡ ุดูˆูุช ุงู„ุญู„ูˆ ู…ุงุจูŠูƒู…ู„ุด ุชุนุงู„ูŠ ุจู‚ูŠ ู†ุนุฑู ุงูƒุชุฑ ุนู†ู‡ ุŸ
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸกุทูŠุจ ุงูŠ ู‡ูŠ Eligibility Criteria ุŸ

ูŠุนู†ูŠ ุงู„ู…ุนุงูŠูŠุฑ ุงู„ู„ูŠ ุจู†ุงุก ุนู„ูŠู‡ุง ู‡ู†ุงุฎุฏ ู‚ุฑุงุฑ ูˆ ู†ุฏูŠ ุงู„ TPA ู„ู„ู…ุฑูŠุถ ูˆู‡ู†ุง ุชุฑูƒุฒู†ุง ุงูƒุชุฑ ุนู„ูŠ ู…ุฑูŠุถ ุงู„ Stroke
โœ”๏ธConfirmed ischemic stroke on CT/MRI (no hemorrhage).
โœ”๏ธOnset of symptoms โ‰ค 4.5 hrs.
โœ”๏ธAge โ‰ฅ 18 years.
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸกุทูŠุจ ุงูŠ ู‡ูŠ Exclusion Criteria ุŸ

๐ŸŸข Absolute Contraindications

โœ”๏ธSignificant head trauma or prior stroke within the past 3 months
โœ”๏ธClinical presentation suggestive of subarachnoid hemorrhage
โœ”๏ธHistory of intracranial hemorrhage
โœ”๏ธElevated blood pressure (systolic >185 mmHg or diastolic >110 mmHg)
โœ”๏ธActive internal bleeding
โœ”๏ธPlatelet count less than 100,000/mm3
โœ”๏ธHeparin use within the past 48 hours
โœ”๏ธINR greater than 1.7

๐ŸŸข Relative Contraindications

โœ”๏ธPregnancy
โœ”๏ธSeizure at onset with postictal residual neurological impairments
โœ”๏ธMajor surgery or severe trauma within the past 14 days
โœ”๏ธRecent gastrointestinal or urinary tract hemorrhage (within the previous 21 days)
โœ”๏ธRecent acute myocardial infarction (within the preceding 3 months)
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
โ˜‘๏ธ ุทูŠุจ ู‡ู†ูŠุฌูŠDosage & Administration

0.9 mg/kg IV (maximum 90 mg)
โ€ข 10% as IV bolus.
โ€ข Remaining 90% infused over 60 minutes.

๐ŸŸฃุทูŠุจ ููŠ ู†ู‚ุทู‡ ู…ู‡ู…ู‡ ููŠ ุงู„ุชุญุถูŠุฑ ู‡ูˆ ุจูŠุฌูŠ ุนุจุงุฑู‡ ุนู† 2 ููŠุงู„ ูˆุงุญุฏ powder ูˆุงู„ุชุงู†ูŠ sterile water ูˆุจูŠุฌูŠ ู…ุนุงู‡ู… ูˆุตู„ู‡ ู…ุฏุจุจู‡ ู…ู† ุงู„ู†ุงุญูŠุชูŠู† ูŠุนู†ูŠ ุงูŠ ู‡ู‚ูˆู„ูƒ ุฑูƒุฒ ู…ุนุงูŠุง ุงูƒูŠุฏ ุดูˆูุช ุฌู‡ุงุฒ ูˆุฑูŠุฏ ู‚ุจู„ ูƒุฏู‡ ุนุงุฑู ุงู„ุฌุฒุก ุงู„ู„ูŠ ุจุชุฑูƒุจู‡ ููŠ ุงู„ู…ุญู„ูˆู„ ู‡ูˆ ุฏู‡ ุงู„ูˆุตู„ู‡ ุจุชูŠุฌูŠ ุจู†ูุณ ุงู„ุดูƒู„ ู…ู† ุงู„ู†ุงุญูŠุชูŠู† ุจู†ุนู…ู„ ุงูŠ ุจู†ุฌูŠุจ ุงู„ sterile water ูˆู†ุญุทู‡ุง ููˆู‚ ููŠุงู„ ุงู„ powder ูˆู†ุณูŠุจ ุงู„ู…ูŠุงู‡ ุชู†ุฒู„ ุจุงู„ gravity ู…ู…ู†ูˆุน ุงู† ุงุญู†ุง ู†ุฑุฌ ุงู„ููŠุงู„ ุจุนู†ู ูˆู‡ุชู„ุงู‚ูŠ ุตูˆุฑู‡ ููŠ ุงู„ comments ุจุชูˆุถุญ ุงู„ู„ูŠ ุจู‚ูˆู„ู‡
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸฃุทูŠุจ ู‡ู†ูŠุฌูŠSide Effects

โ€ข Major risk: Bleeding (esp. Intracranial hemorrhage).
โ€ข Hypotension.
โ€ข Rare allergic reactions.
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸฃุทูŠุจ ู‡ู†ูŠุฌูŠ ุจู‚ูŠ ู„ุดุบู„ู†ุง ุงุญู†ุง ูˆุฏูˆุฑู†ุง ุงูŠ ูƒุชู…ุฑูŠุถ ุฑูƒุฒ ู…ุนุงูŠุง ุจู‚ูŠ ุงู„ Nursing Care of TPA ุจู†ู‚ุณู…ู‡ ู„ุชู„ุงุช ุญุฌุงุช ุงูŠู‡ ู‡ู…ุง Before, During & After

๐Ÿ”ตBefore administration

โ€ข Check the criteria of thrombolytic therapy
โ€ข Obtain baseline vital signs, especially blood pressure, and neurological status.
โ€ข Ensure IV access is secure.
โ€ข Ensure that the consent signed

๐Ÿ”ต During administration

โ€ข Vital signs every 15 minutes.
โ€ข Neurological assessments every 15 minutes to detect early signs of intracranial hemorrhage or neurological deterioration.
โ€ข Watch for any signs of bleeding (gums, urine, stool, injection sites).
โ€ข Monitor for allergic reactions including rash or swelling.
โ€ข Discontinue infusion and obtain an emergency CT scan if the patient develops severe headache, acute hypertension, nausea, or vomiting, or has a worsening neurologic examination

๐Ÿ”ต After administration

โ€ข Perform neurologic assessment & VS every 30 minutes for 6 hours and then every 1 hours.
โ€ข Avoid invasive procedures (e.g., catheter insertions, IM injections) for 24 hours post-treatment to minimize bleeding risk.
โ€ข Keep patient on strict bed rest for at least 12 hours.
โ€ข Do not give anticoagulants or antiplatelet drugs for 24 hours post TPA unless ordered by physician.
โ€ข Monitor closely for signs of intracranial hemorrhage or other bleeding complications.
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸฃ Tenecteplase (TNK)

ู‡ู†ูŠุฌูŠ ุจู‚ูŠ ู„ู„ TNK ูˆุฏู‡ ุจุนุฏู‡ ูƒุฏู‡ ู‡ูˆ ุงู„ู„ูŠ ู‡ูŠูƒูˆู† ู…ูˆุฌูˆุฏ ูˆู‡ูŠุชู… ุงุณุชุฎุฏุงู…ู‡ ููŠ ุงู„ู…ุณุชุดููŠุงุช ู‡ูˆ ู†ุณุฎุฉ ู…ุทูˆุฑุฉ ู…ู† TPA ูˆูŠุนู…ู„ ุจู†ูุณ ุงู„ู…ูŠูƒุงู†ูŠุฒู… ุฅุฐุงุจุฉ ุงู„ุฌู„ุทุงุช ุนู† ุทุฑูŠู‚ ุชู†ุดูŠุท plasminogen
ู„ูƒู† ูŠุชู…ูŠุฒ ุจู€:
โœ”๏ธ Half-life ุฃุทูˆู„
โœ”๏ธ Fibrin specificity ุฃุนู„ู‰
โœ”๏ธ ุฃุณู‡ู„ ููŠ ุงู„ุงุณุชุฎุฏุงู…
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐ŸŸฃ ุทุจ ุงูŠ ุงู„ูุฑู‚ ู…ุงุจูŠู† ุงู„ TPA & TNK

๐Ÿ”ด TPA (Alteplase)

โ€ข Bolus + infusion ู„ู…ุฏุฉ 60 ุฏู‚ูŠู‚ุฉ
โ€ข Half-life ู‚ุตูŠุฑ
โ€ข Dose 0.9 mg/kg

๐ŸŸฃ TNK (Tenecteplase)

โ€ข Single IV bolus ูู‚ุท
โ€ข Half-life ุฃุทูˆู„
โ€ข Dose 0.25 mg/kg
โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”
๐Ÿ’ฌ ุณุคุงู„ ู„ุฒู…ุงูŠู„ู†ุง ููŠ ุงู„ุชู…ุฑูŠุถ:
ู‡ู„ ููŠ ุญุฏ ุดุงู ุงู„ TNK ูˆู„ุง ู„ุณู‡
Save ๐Ÿ“Œ ุงู„ุจูˆุณุช ู„ู„ู…ุฑุงุฌุนุฉ ูˆุงุนู…ู„ ุดูŠุฑ ุนุดุงู† ูŠูˆุตู„ ู„ุบูŠุฑูƒ
ุดูƒุฑุง ุฌุฒูŠู„ุง ุงุชู…ู†ูˆุง ุชูƒูˆู†ูˆุง ุงุณุชูุฏุชูˆุง





๐ŸŸค ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ๐Ÿคุงู„ู†ู‡ุงุฑุฏู‡ ู‡ู†ุชูƒู„ู… ุนู† ู…ูˆุถูˆุน ู…ู‡ู… ุฌุฏู‹ุง ูˆูƒู„ ุฏู‚ูŠู‚ุฉ ููŠู‡ ุจุชูุฑู‚โ€ฆ๐Ÿ›‘ Stroke (ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ)โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”๐ŸŸก ูŠุนู†ูŠ...
03/03/2026

๐ŸŸค ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ๐Ÿค
ุงู„ู†ู‡ุงุฑุฏู‡ ู‡ู†ุชูƒู„ู… ุนู† ู…ูˆุถูˆุน ู…ู‡ู… ุฌุฏู‹ุง ูˆูƒู„ ุฏู‚ูŠู‚ุฉ ููŠู‡ ุจุชูุฑู‚โ€ฆ
๐Ÿ›‘ Stroke (ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ)

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐ŸŸก ูŠุนู†ูŠ ุงูŠู‡ Stroke ุŸ

ู‡ูŠ ุญุงู„ุฉ ุทุจูŠุฉ ุทุงุฑุฆุฉ ุจุชุญุตู„ ู„ู…ุง ุงู„ุฏู… ูŠูˆุตู„ ู„ู„ู…ุฎ ุจุดูƒู„ ู‚ู„ูŠู„ ุฃูˆ ูŠุชูˆู‚ู ุชู…ุงู…ู‹ุงุŒ
ูˆุฏู‡ ุจูŠู…ู†ุน ูˆุตูˆู„ ุงู„ุฃูƒุณุฌูŠู† ูˆุงู„ุฌู„ูˆูƒูˆุฒ ู„ุฎู„ุงูŠุง ุงู„ู…ุฎ โžœ ูˆุจุงู„ุชุงู„ูŠ ุงู„ุฎู„ุงูŠุง ุจุชุจุฏุฃ ุชู…ูˆุช ุฎู„ุงู„ ุฏู‚ุงุฆู‚.

๐Ÿ›‘ ูƒู„ ุฏู‚ูŠู‚ุฉ ุชุฃุฎูŠุฑ = ูู‚ุฏุงู† ุนุฏุฏ ูƒุจูŠุฑ ู…ู† ุฎู„ุงูŠุง ุงู„ู…ุฎ.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

โญ• Types of Stroke

ุนู†ุฏู†ุง 3 ุฃู†ูˆุงุน ุฑุฆูŠุณูŠุฉ:

โœ… 1) Ischemic Stroke
โ€ข ุงู†ุณุฏุงุฏ ููŠ ูˆุนุงุก ุฏู…ูˆูŠ (Thrombus ุฃูˆ Embolus).
ูˆุฏู‡ ุงู„ู†ูˆุน ุงู„ุฃุดู‡ุฑ.

โœ… 2) Hemorrhagic Stroke
โ€ข ุงู†ูุฌุงุฑ ูˆุนุงุก ุฏู…ูˆูŠ ูˆุญุฏูˆุซ ู†ุฒูŠู ุฏุงุฎู„ ุงู„ู…ุฎ.
ูˆูŠู†ู‚ุณู… ุฅู„ู‰:

- Intracerebral hemorrhage
- Subarachnoid hemorrhage

โœ… 3) Transient Ischemic Attack (TIA)
โ€ข "Mini-stroke"
โ€ข ุฃุนุฑุงุถ ู…ุคู‚ุชุฉ ุฃู‚ู„ ู…ู† 24 ุณุงุนุฉ
โ€ข ุฅู†ุฐุงุฑ ู‚ูˆูŠ ุจุญุฏูˆุซ ุฌู„ุทุฉ ูƒุงู…ู„ุฉ ู„ุงุญู‚ู‹ุง.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐ŸŸฆ Risk Factors

โ˜‘๏ธ Non-modifiable (ู…ุด ุจู†ู‚ุฏุฑ ู†ุชุญูƒู… ููŠู‡ุง):

- ุงู„ุณู†
- ุงู„ู†ูˆุน
- ุชุงุฑูŠุฎ ุนุงุฆู„ูŠ
- ุฅุตุงุจุฉ ุณุงุจู‚ุฉ ุจู€ Stroke ุฃูˆ TIA

โ˜‘๏ธ Modifiable (ู†ู‚ุฏุฑ ู†ุชุญูƒู… ููŠู‡ุง ูˆุฏู‡ ุงู„ู…ู‡ู…):

- Hypertension (ุฃู‡ู… ุณุจุจ)
- Diabetes
- Smoking
- High cholesterol
- Obesity & inactivity
- Atrial fibrillation
- Excess alcohol

ู…ุซุงู„ ุจุณูŠุท ๐Ÿ‘‡
ู…ุฑูŠุถ ุถุบุท โ†’ ูŠู„ุชุฒู… ุจุงู„ุนู„ุงุฌ + ูŠุชุงุจุน ุถุบุทู‡ + ูŠุธุจุท ุฃูƒู„ู‡
ูƒุฏู‡ ู‚ู„ู„ ุฎุทุฑ ุฅุตุงุจุชู‡ ุจุงู„ุฌู„ุทุฉ ุจุดูƒู„ ูƒุจูŠุฑ.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

โ˜‘๏ธ Signs & Symptoms (ู…ู‡ู…ุฉ ุฌุฏู‹ุง)

ุงู„ุฃุนุฑุงุถ ุจุชุธู‡ุฑ ูุฌุฃุฉ:

โ€ข ุถุนู ุฃูˆ ุชู†ู…ูŠู„ ููŠ ุงู„ูˆุฌู‡ ุฃูˆ ุงู„ุฐุฑุงุน ุฃูˆ ุงู„ุฑุฌู„ (ุบุงู„ุจู‹ุง ู†ุงุญูŠุฉ ูˆุงุญุฏุฉ)
โ€ข ุตุนูˆุจุฉ ููŠ ุงู„ูƒู„ุงู… ุฃูˆ ุงู„ูู‡ู…
โ€ข ู…ุดุงูƒู„ ู…ูุงุฌุฆุฉ ููŠ ุงู„ุฑุคูŠุฉ
โ€ข ุฏูˆุฎุฉ ุฃูˆ ูู‚ุฏุงู† ุชูˆุงุฒู†
โ€ข ุตุฏุงุน ุดุฏูŠุฏ ู…ูุงุฌุฆ ุจุฏูˆู† ุณุจุจ ูˆุงุถุญ

๐Ÿ›‘ ูˆุงูุชูƒุฑูˆุง ุงู„ู‚ุงุนุฏุฉ ุงู„ุฐู‡ุจูŠุฉ:

FAST
F โ†’ Face drooping
A โ†’ Arm weakness
S โ†’ Speech difficulty
T โ†’ Time to call emergency

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐ŸŸ  Diagnosis

โ€ข Physical examination
โ€ข Blood tests
โ€ข CT scan
โ€ข MRI
โ€ข Carotid duplex
โ€ข Cerebral angiography
โ€ข Echocardiography
โ€ข Trans-Esophageal Echo (TEE)

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐ŸŸ  Treatment

ุงู„ุนู„ุงุฌ ุจูŠุนุชู…ุฏ ุนู„ู‰ ู†ูˆุน ุงู„ู€ Stroke ๐Ÿ‘‡

๐Ÿ”ต ุฃูˆู„ู‹ุง: Ischemic Stroke
ุงู„ู‡ุฏู: ุงุณุชุฑุฌุงุน ุชุฏูู‚ ุงู„ุฏู… ุจุณุฑุนุฉ.

โ€ข Thrombolytic therapy (tPA)
ุฏูˆุงุก ู…ุฐูŠุจ ู„ู„ุฌู„ุทุฉ ูˆู„ูŠู‡ ุดุฑูˆุท ู…ุนูŠู†ุฉ.

โ€ข Mechanical thrombectomy
ุฅุฌุฑุงุก ุจุงู„ู‚ุณุทุฑุฉ ู„ุฅุฒุงู„ุฉ ุงู„ุฌู„ุทุฉ ุฃุซู†ุงุก Cerebral angiography.

โณ ุงู„ูˆู‚ุช ุนุงู…ู„ ุญุงุณู… ุฌุฏู‹ุง ููŠ ุงู„ู†ูˆุน ุฏู‡.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐Ÿ”ด ุซุงู†ูŠู‹ุง: Hemorrhagic Stroke
ุงู„ู‡ุฏู: ุฅูŠู‚ุงู ุงู„ู†ุฒูŠู ูˆุชู‚ู„ูŠู„ ุงู„ุถุบุท ุฏุงุฎู„ ุงู„ู…ุฎ.

โ€ข Control blood pressure
โ€ข ุชุฏุฎู„ ุฌุฑุงุญูŠ ุนู†ุฏ ุงู„ุญุงุฌุฉ:

- Clipping
- Coiling
- Evacuation of hematoma

ูˆุงู„ู‚ุฑุงุฑ ุจูŠูƒูˆู† ุญุณุจ ุญุฌู… ูˆู…ูƒุงู† ุงู„ู†ุฒูŠู ูˆุชู‚ูŠูŠู… ุฌุฑุงุญุฉ ุงู„ู…ุฎ ูˆุงู„ุฃุนุตุงุจ.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐ŸŸข ู„ูŠู‡ ุงู„ู€ Atrial Fibrillation ุจุชุนู…ู„ ุฌู„ุทุฉุŸ

ููŠ AF ุงู„ุฃุฐูŠู† ุจูŠุจู‚ู‰ ุจูŠุฑุชุนุด ุจุฏู„ ู…ุง ูŠู†ู‚ุจุถ ุทุจูŠุนูŠ โžœ
ุงู„ุฏู… ูŠุฑูƒุฏ ุฏุงุฎู„ ุงู„ุฃุฐูŠู† โžœ ุชุชูƒูˆู† ุฌู„ุทุงุช โžœ
ุงู„ุฌู„ุทุงุช ุฏูŠ ู…ู…ูƒู† ุชุทู„ุน ูˆุชุฑูˆุญ ู„ู„ู…ุฎ ูˆุชุณุจุจ Stroke.

ุทุจ ุงูŠู‡ ู‡ูˆ TEEุŸ
ุฏู‡ Echocardiography ุจุงู„ู…ู†ุธุงุฑ ุจูŠุฏูŠู†ุง ุตูˆุฑุฉ ุฃูˆุถุญ ู„ูˆ ููŠู‡ ุฌู„ุทุงุช ุฏุงุฎู„ ุงู„ุฃุฐูŠู†ุŒ ูˆุจูŠุณุงุนุฏู†ุง ู†ู‚ุฑุฑ ู…ูˆุถูˆุน ุงู„ู€ Anticoagulation.

โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”โ”

๐Ÿ›‘ ููŠ ุงู„ู†ู‡ุงูŠุฉโ€ฆ

ุงู„ุณูƒุชุฉ ุงู„ุฏู…ุงุบูŠุฉ ุญุงู„ุฉ ุทุงุฑุฆุฉ.
ูƒู„ ุฏู‚ูŠู‚ุฉ ุจุชูุฑู‚.
ุงู„ุชุดุฎูŠุต ูˆุงู„ุนู„ุงุฌ ุงู„ุณุฑูŠุน ู…ู…ูƒู† ูŠู†ู‚ุฐ ุญูŠุงุฉ ุดุฎุต ูˆูŠู…ู†ุน ุฅุนุงู‚ุฉ ุฏุงุฆู…ุฉ.

๐Ÿ’™

ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ุงู† ุดุงุก ุงู„ู„ู‡ ุงู„ู†ู‡ุงุฑุฏู‡ ู‡ู†ุชูƒู„ู… ุนู„ูŠ ู…ูˆุถูˆุน ู…ู‡ู… ูˆู‡ูˆ ๐Ÿ”˜ International Patient Safety Goals๐Ÿ”ฐ ๐ŸŸค ุงูˆู„ุง ุชุนุงู„ูŠ ู†ุนุฑู ูŠุนู†ูŠ ...
20/02/2026

ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ุงู† ุดุงุก ุงู„ู„ู‡ ุงู„ู†ู‡ุงุฑุฏู‡ ู‡ู†ุชูƒู„ู… ุนู„ูŠ ู…ูˆุถูˆุน ู…ู‡ู… ูˆู‡ูˆ

๐Ÿ”˜ International Patient Safety Goals๐Ÿ”ฐ

๐ŸŸค ุงูˆู„ุง ุชุนุงู„ูŠ ู†ุนุฑู ูŠุนู†ูŠ ุงูŠ Patient Safety

๐ŸŸค the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care

๐Ÿ”ด ุนุงูŠุฒูƒ ุชุงุฎุฏ ุจุงู„ูƒ ููŠ ุงู„ุชุนุฑูŠู ู‚ู„ูƒ preventable harm ู„ูŠู‡ ู„ุงู† ุฏู‡ ุถุฑุฑ ุงู‚ุฏุฑ ุงู…ู†ุนู‡ุง ุจุชู†ููŠุฐ ุงู„ุชุนู„ูŠู…ุงุช ุงู„ุตุญูŠุญู‡

โ˜‘๏ธ ุทูŠุจ ุนุงูŠุฒ ุงูƒู„ู… ู…ุนุงูƒ ููŠ ุงุญุตุงุฆูŠู‡ ูƒุฏู‡ ู…ุตุฏุฑู‡ุง (World health organization 2024) ุจุชู‚ูˆู„ ุงูŠ ุจู‚ูŠ ๐Ÿค”

๐Ÿ”˜ Around 1 in every 10 patients is harmed in health care and more than 3 million deaths occur annually due to unsafe care. In low-to-middle income countries, as many as 4 in 100 people die from unsafe care

๐ŸŸค ุงุญุตุงุฆูŠู‡ ู…ุฑุนุจู‡ ูˆุชุจูŠู†ู„ูƒ ุงู‡ู…ูŠู‡ ุชุทุจูŠู‚ ุงู„ IPSGs ูˆุงู†ุง ู‚ู„ุช ุชุทุจูŠู‚ ู„ูŠู‡ ู„ุงู† ู„ู„ุงุณู ู…ุนุธู… ุงู„ุงุณุชุงู ู…ู…ูƒู† ูŠูƒูˆู† ุนุงุฑูู‡ู… ูˆูŠู‚ุฏุฑ ูŠุณู…ุนู‡ู… ู„ูƒู† ุนู„ูŠ ุงุฑุถ ุงู„ูˆุงู‚ุน ู…ุด ุจูŠุทุจู‚ู‡ู…

ุชุนุงู„ูŠ ู†ุนุฑู ุงูŠ ู‡ู…ุง ุงู„ IPSGs ุŸ ๐Ÿค” ๐Ÿ“ข

๐ŸŸก IPSG 1: Identify patient correctly

๐ŸŸค IPSG 2: Improve Effective Communication.

๐Ÿ”ด IPSG 3: Improve the Safety of High-Alert Medications.

๐Ÿ”ต IPSG 4: Ensure Correct-Site, Correct-Procedure, Correct-Patient Surgery.

๐ŸŸข IPSG 5: Reduce the Risk of Health Careโ€“Associated-Infections

๐Ÿ”ตุทูŠุจ ู‡ุชู„ุงู‚ูŠู†ูŠ ุดุงุฑุญ ูƒู„ ุฌูˆู„ ุจุงู„ุชูุตูŠู„ ููŠ ููŠุฏูŠูˆ ุนู„ูŠ ุงู„ูŠูˆุชูŠูˆุจ ูˆู‡ุชู„ุงู‚ูŠ ุงู„ู„ูŠู†ูƒ ููŠ ุงูˆู„ ูƒูˆู…ู†ุช

๐Ÿ”ด ุทูŠุจ ู‡ุชู„ุงู‚ูŠ ูƒู…ุงู† ุงู„ู…ุญุงุถุฑู‡ ูƒุงู…ู„ู‡ PDF ุนู„ูŠ ู„ูŠู†ูƒ ุฌูˆุฌู„ ุฏุฑุงูŠู ููŠ ุงู„ูƒูˆู…ู†ุช

ุดูƒุฑุง ุฌุฒูŠู„ุง ุงุชู…ู†ูˆุง ุชูƒูˆู†ูˆุง ุงุณุชูุฏุชูˆุง๐Ÿ’™

24/01/2026

๐Ÿ”ต ุงู„ุชู…ุฑูŠุถ ู…ุด ุดุบู„ ูˆุฎู„ุงุต ุงู„ุชู…ุฑูŠุถ ุฑุณุงู„ู‡ ูˆุฅู†ุณุงู†ูŠุฉ
๐ŸŸฃ ุญูƒุงูŠู‡ ุงุจุชุฏูŠุช ู…ู† ุฒู…ุงู† ุฌุฏุง ูˆุจู‚ูŠ ุนู„ู… ูˆูู†
โšซ ุงู„ุชู…ุฑูŠุถ ู‡ูˆ ุงุณุงุณ ุงูŠ ุฑุนุงูŠุฉ ุตุญูŠุฉ

21/01/2026

ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ูˆุฑุญู…ู‡ ุงู„ู„ู‡ ุงู†ุง ุนู…ู„ุช ุงู„ุตูุญู‡ ุฏู‡ ุนุดุงู† ุงู†ุฒู„ ุนู„ูŠู‡ุง ุงูŠ ู…ุนู„ูˆู…ุงุช ุงูˆ ููŠุฏูŠูˆู‡ุงุช ุชุฎุต ุงู„ุชู…ุฑูŠุถ ูˆุชู‚ุฏุฑ ุชุณุงุนุฏูƒ ุงู† ุดุงุก ุงู„ู„ู‡ ุนุดุงู† ุชูƒูˆู† ู…ู…ุฑุถ ูƒูุงุก

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