Chapter 8: Neurological support Flashcards
How to prevent abnormal oxygen demands (5)
- Avoid Fever
- Seizure prophylaxis
- avoid anxiety and agitation
- avoid shivering
- minimize stimulation especially for first 72 hours
3 components of GCS
Eye opening
verbal response
motor response
When clinical findings suggest herniation emergent administration of ____ or _____ should be administered to lower ICP
Manitol or hypertonic saline
What is Cushing reflex
HTN followed by bradycardia and altered respiration, may indicate brain herniation
cerebellar hemorrhage with ___ ____ is a surgical emergency
altered consciousness
What % of patients with sever TBI have cervical spine injuries
20
what fluid to use for TBI
NS don’t use hypotonic fluids
Can you use steroids with TBI
no
How long to use prophylactic anticonvulsants after TBI
1 week
____ ____ for 12-24 hours improves neurologic outcomes in comatose patients after cardiac arrest
systemic cooling
when can an LP be done without CT
no papilledema of focal neurologic defects
In adult patients with depressed conciousness after initial resuscitation use___ and ___
50% dextrose and thiamine for possible hypoglycemia and to prevent wernicke’s
why should you try to avoid neuromuscular blocking agents in patients at risk for seizure
they can obscure seizure activity
lorazepam dose status
.1 mg/kg IV
when to give Midazolam instead of lorazepam for status
no IV acces, can give IM
