Quote from mistydawnrn06
...the mds won't make a move without evidence based practice.
what, your docs don't know how to do a literature search?
the aann has a clinical practice guideline on management of the patient with tbi.
click on the link. you'll be asked to answer a couple of question, then you can download the guideline free of charge
i used to love propofol, but i don't trust it anymore. it's meant for short-term use only, and too many times i've seen patients on it for several days who don't wake up for as many days after it's turned off. i prefer midazolam.
i used to see thorazine used to treat neurogenic hyperthermia, but haven't seen that used in many years. i use a cooling blanket. use a rectal temperature probe if you can get one - it will prevent a lot of grief. i've been told that you can prevent shivering by keeping the hands warm (cover them with socks), but i've never tried it myself.
i haven't put someone in a barb coma for many years. i remember one article a read within that last few years that said barb comas are considered a last-ditch effort. one thing i remember about keeping people in barb comas is to do meticulous mouth care - make sure you suction out the oropharynx and nasopharynx - otherwise the secretions pool and rot. h2o2 is your friend.