Neuro 4 Flashcards
Using PEEP or PAP decreases
MAP and CPP
A rise in mean airway pressure can increase
ICP
Induced hypernatremia
increases CPP and decreases intracerebral pressure
where is hypertonic saline given
2% saline can be given peripheral, 3% or higher is given central
hyperventilation or any lowering/drop of CO2 less than 25 mmHg will cause…
vasoconstriction to the cerebral arteries.
what is limited in neuro pts as it increases ICP
Suctioning is limited to 5-10 seconds and no coughing
describe Permissive hypercapnia
Allow CO2 to go a little higher, allows them to have a better depth of respiration
if GCS less than 8 goals are…
Reduce agitation, discomfort and pain
Use mechanical ventilation to decrease coughing
Limit suctioning
if sedating neuro pt what is important to remember
must be able to wake them up! (need to know if sedated d/t increased ICP or just meds)
what can paralyzation cause
may decrease brain activity
what meds are used most often for ICP
Ativan/Lorazepam and Fentanyl drips used most often
what is a Barbiturate coma
- to put into sedated coma to reduce brain metabolism
- used for less than 72 hours
- Used GCS less than 7, ICP greater than 25
other than coma, what is used to slow brain metabolism
hypothermia
what drug reverses a paralyzing agent
romazicon
what type of additional management when dealing with increased ICP
Blood Pressure management to keep normotensive, avoid MAP greater than 110
