Topics to study before Trauma/neuro SICU internship

[bpf1987]

I'll start my preceptorship (last big clinical one-on-one with RN) in September on a Trauma/Neuro SICU. I want to pre-game a bit. If you guys could throw me some essentials to learn before-hand I would appreciate it. I've been an ER tech at a level one for 5 years so I know the ICU will be a whole new world and I would like to be prepared as possible. So meds, lab values, procedures whatever.

Thanks

Brittany

[NurseKitten, MSN, RN]

Ventriculostomies

Camino bolts

Spinal cord injuries

Subdural/epidural hematomas - what are they, what is the difference.

Subarachnoid hemmorages

Indications for craniotomies

Refresh your neuro A&P, including areas of the brain, blood flow pathways of brain and spinal cord, and CSF flow.

More to come as I think of them...

Come on, neuro folks - what am I missing here, 'cause I know this isn't everything!

[NurseKitten, MSN, RN]

Go to www.pearlsreview.com and look in some of their trauma CE's. Tampa General also has a GREAT (and FREE) CE website that has a lot of good trauma stuff to study.

[meandragonbrett]

Traumatic Brain Injury

Cereberal Ischemia

Assessment of the neurologically impaired

ICP and Monroe-Kellie theory

What s/sx would alert you to changes in ICP (when you don't have a bolt or EVD)

Propofol vs. midazolm in the neuro patient. Complications from propofol in the neuro patient.

Neuro Temps

Meningitis

Spinal Precautions

C-Spine injuries. Para vs. quad.

Bradycardia in neuro injury

vasospam in neuro injuries

Hypertonic saline use

Osmotic diuretics

Management of acidosis/CO2 in the head patient and how that affects ICP

Pentobarb comas

Subarachnoid, subdural, and epidural hematoma

Diffuse Axonal Injury.

Chest trauma

Myocardial Contusion

Care of the patient with chest tubes and s/p thoracotomy

Compartment syndrome

Abdominal compartment syndrome-->s/sx on the ventilator, assessment, lab changes, what do you do for it?

You will likely have lots of open bellies in a Trauma ICU. Open to vicryl mesh or cassette.

Multi system organ failure.

Sepsis and septic shock.

Trauma tends to use a lot of pulmonary artery catheters. Know your hemodynamic profiles of various shock states.

Acute renal failure

Rhabdo as a result of crushing injury

Dopamine, Epi, Vasopressin, Norepi, Neo, Dobutamine

the role of crystalloid vs. colloid in trauma. Transfusion in the trauma patient. The coagulation cascade. Vertebral artery injuries.

Just a few things to give you some stepping stones of what you'll see in a trauma ICU.

[bpf1987]

Yes this is perfect thanks a lot

[NurseKitten, MSN, RN]

This month's "Critical Care Nurse" has a good CE article on Traumatic Brain Injuries - nice way to go in being "up" on the current EBP and looking like a rockstar. :)