Medical Scenario III

[Trapper John]

Originally Posted by PedOncoDoc

TIA can only be diagnosed in hindsight - if symptoms last for <24 hours without residual neurologic sequelae. I would consider this an acute thromboembolic stroke until proven otherwise.

If she seemed confused this morning, the stroke could've happened overnight, so it may not be outside of the therapeutic window for TPA. Then again - I coudln't tell you the last time I took care of an acute stroke in an elderly patient with AF, so I'm not sure on SOPs here.

I think a baby aspirin is 81mg (not 80), and (getting on my pediatric high horse here) never give aspirin to a pediatric patient unless advised to do so by a cardiologist.

Thanks for the info Doc! Yeah, 81 mg (not 80 mg). Rounding error

I have often wondered why the 81 mg aspirin was called "baby aspirin" anyway. I always thought it contra-indicated in children under 2 yo (maybe even 3 yo)?

[PedOncoDoc]

Originally Posted by Trapper John

Thanks for the info Doc! Yeah, 81 mg (not 80 mg). Rounding error

I have often wondered why the 81 mg aspirin was called "baby aspirin" anyway. I always thought it contra-indicated in children under 2 yo (maybe even 3 yo)?

We worry about Reye syndrome if children receive ASA while having viral illness - so it is not used in children <12 if recovering from varicella or flu-like illness. ASA is only used in children with a clear cardiac indication or an acute thromboembolic stroke. ASA can be used at any age (no absolute age cutoff), but we are very careful about dosing.

Back to the scenario: Looking at current ASA guidelines, I would administer 325mg x1 with plans for a baby ASA daily thereafter.