Overstimulation in comatose patients - page 2
by derelys9 4,352 Views | 11 Comments
Since a loved one has been in the NeuroICU for the past month (TBI, multiple broken bones and internal injuries due to motorcycle accident) I (as well as other family members) have been told off and on "oh don't talk to him,... Read More
- 0Jan 11, '06 by ADDnurseIf you read the post the ICP had stabilized when the drain was pulled and as far as using hypothermia in a Hunt-Hess grade 5, whats the point? The real danger is from cerebral vasospasm, and cooling the patient will not effect that to any significant degree, I'd be more interested in triple H therapy in that case, or cerebral angioplasty at the first sign of vasospasm, with a ventriculostomy to help control the ICP. As to a lot has changed in NSICU in 6 years, actually it's 5, but my friends and wife still work bedside, so I'm not as removed as you assume, and not that much has changed! However I would be interested to know if others are using hypothermia as much as your institution, also I'd be interested in the protocols and standards for the use: are the patients swan'd? obviously vented, what is considered the optimal temp, is there any specialized equipement needed, beds, cooling systems, and are there any particular electrolyte problems that occur?
Thanks TNN talk to you later.
- 0Mar 2, '06 by auzzieneuronurseHello all,
I am just new to this and work on a neurosurgical ward not in ICU but has anyone mentioned PTA (post traumatic amnesia)?????? This occurs post TBI and can last from days to weeks to months depending on the severity of injury - it impairs the brains ability to lay down short term memory and leads to behaviours such as aggitation, impulsiveness, lack of insight into condition etc. We nurse PTA patients in a low stimulus environment, quiet single room, gentle reorientation, encourage families and friends to visit two at a time and not to overstimulate them and bombard them with a lot of new information. PTA patients need rest++++ so I encourage families to sit quietly with them. Any help??