Haemorrhagic Stroke Clerking

Evidence-based acute haemorrhagic stroke clerking tool. ICH score · Anticoagulation reversal · BP management · Neurosurgical criteria.

ICH Clerking is a clinical decision-support tool designed for use by neurologists, stroke physicians, and junior doctors managing acute intracerebral haemorrhage (ICH) presentations. The app provides a structured, evidence-based clerking framework covering all stages of the acute haemorrhagic stroke pathway - from initial assessment through to anticoagulation reversal, BP management, neurosurgical referral, and management planning. Features include:

Structured patient assessment with pre-morbid functional status (modified Rankin Scale) Symptom checklist with 16 ICH-specific symptoms and clinical prompts Full history including ICH-specific risk factors, anticoagulant type and last dose NIHSS calculator (all 15 items) with automatic severity grading Vital signs with real-time clinical alerts (BP target less than 140, INR, platelets, temperature) CT/CTA imaging with ABC/2 ICH volume calculator, location-specific alerts, IVH, spot sign ICH Score calculator (Hemphill 2001) with automatic 30-day mortality prediction Anticoagulation reversal guidance - Warfarin (auto PCC dose by INR and weight), idarucizumab, andexanet alfa, protamine - with haematology referral prompt BP management - SBP target less than 140 mmHg within 1 hour per INTERACT2/ATACH-2 Neurosurgical referral criteria including cerebellar ICH, hydrocephalus, EVD/ICP criteria, and STICH evidence summary Acute management plan checklist with select all function Time target stopwatch with one-tap checkpoints Auto-generated clinical summary of all positive findings for consultant handover with copy to clipboard Fully cited references (AHA/ASA 2022, NICE NG128, INTERACT2, ATACH-2, STICH I/II, PATCH trial, Hemphill 2001)

Important: This app is intended for use by licensed and registered healthcare professionals only. It does not replace clinical judgement, local protocols, or consultant review. No patient data is collected, stored, or transmitted.