Traumatic or Hypoxic Brain Injury

Question 1

Why is EtCO2 important in Traumatic or Hypoxic Brain Injury?

Answer 1

Detect hypoventilation before hypoxia manifests

Question 2

What is our ideal range for SpO2 in a Traumatic or Hypoxic Brain Injury?

Answer 2

> 94%

Question 3

What is our ideal range for EtCO2 in an intubated patient with a Traumatic or Hypoxic Brain Injury?

Answer 3

30-35mmHg

Question 4

What is our Saline protocol in Traumatic or Hypoxic Brain Injury?

Answer 4

10mL/kg aliqouts (max 250mL) up to 20mL/kg
- >14 years aim to maintain MAP >90mmHg or SBP >110mmHg
- <14 aim to maintain normal SBP for age

Question 5

Protocol for managing an agitated patient with a Traumatic or Hypoxic Brain Injury and SBP >11mmHg?

Answer 5

IV Midazolam
- 14-64 years up to 1mg
- >65 years up to 0.5mg
-slow push over 1 min
-repeat every 5 mins
-Total max of 5mg
IM Midazolam
-14-64 years 25mcg/kg to max dose of 2.5mg
-consult for over 65 years

Question 6

Protocol for managing an agitated patient with a Traumatic or Hypoxic Brain Injury where Midazolam is inappropriate or ineffective?

Answer 6

IV/IO Ketamine
-14-64 years 25-50mg
-slow push over 1 min
-Repeat 25mg Ketamine if ineffective after 5 mins
-Max dose of 75mg
-Consult over 65 years