Neurocritical Care

by Adams, John P.; Bell, Dominic; Mckinlay, Justin

• ISBN13: 9781848820692
• ISBN10: 1848820690
• Edition: 1st
• Format: Paperback
• Copyright: 2009-12-30
• Publisher: Springer Verlag

Summary

Traumatic brain injury is the leading cause of death in young people in the UK and USA. The vast majority of these patients will be initially managed outside the teaching hospital environment and many will remain there for the duration of their treatment. As clinicians, what happens during the first hours and days after injury can have a huge influence on the patient's chance of survival and also their quality of life after the injury.Results of a recent national survey have highlighted 2 main areas of major concern. Firstly, there are far too few specialist neurosurgical beds in out tertiary referral centres, which means that District General Hospital Intensive Care Units are frequently having to manage very seriously brain injured patients. Secondly, many clinicians do not know when they should be speaking to their Regional Neurosurgical Centre, do not fully understand how they should be managing these patients, do not know how to interpret the relevant physiological and radiological data, and have difficulty identifying when to escalate treatment and when the situation has become futile.Lives could therefore be saved and outcomes improved with the introduction of common treatment pathways and better defined lines of communication between referring hospitals and specialist centres.

Author Biography

John P. Adams, MB ChB MRCP FRCA is Consultant Anesthetist with an interest in Neuroanesthesia and Anesthesia for Endocrine Surgery at Leeds Teaching Hospitals NHS Trust, UK. Dominic Bell, MPhil MBChB FRCA is Consultant in Intensive Care and Anesthesia at Leeds Teaching Hospitals NHS Trust, UK. Justin McKinlay, MA(Oxan) MB BCh FRCA is Consultant Anesthetist and Honorary Senior Lecturer at Leeds Teaching Hospitals NHS Trust, UK.

Table of Contents

Brain Injury and Dysfunction: The Critical Role of Primary Management	p. 1
Monitoring the Injured Brain	p. 9
The Secondary Management of Traumatic Brain Injury	p. 19
Critical Care Management of Subarachnoid Hemorrhage	p. 33
Central Nervous System Infections	p. 43
Cervical Spine Injuries	p. 51
Recent Advances in the Management of Acute Ischemic Stroke	p. 61
Seizures on the Adult Intensive Care Unit	p. 69
Non-Neurological Complications of Brain Injury	p. 77
Acute Weakness in Intensive Care	p. 89
Coma, Confusion, and Agitation in Intensive Care	p. 97
Death and Donation in Critical Care: The Diagnosis of Brainstem Death	p. 105
Death and Donation in Critical Care: Management of Deceased Organ Donation	p. 113
Imaging the Brain-Injured Patient	p. 121
Ethical Dilemmas Within Intensive Care	p. 137
Appendices	p. 145
Index	p. 173
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