A 30 year old bricklayer has fallen 3m off scaffolding onto the hard ground below and has been unable to mobilise since the incident. The patient presents complaining of back pain with associated altered motor function and sensation to his lower limbs. He is GCS 15 and his vital signs read a BP 80/40 mmHg, Heart Rate 47bpm, Oxygen Saturations of 100% on room air and his temperature is 37 degrees Celsius. He has warm hands and feet. On examination you notice that power of his lower limbs is 0/5 in all myotomes and he cannot appreciate sensation below the dermatome level of T4.Read More
In part 1 we described some of the key concepts of identifying signs of raised ICP and discussed some of the herniation syndromes. Now let’s take a look at the key concepts of managing patients with raised ICP in the ED.
During your primary survey, you noticed his left pupil is dilated and non-reactive.
A 37-year-old man has been ejected from his car after crashing at high speed. He was initially mildly confused but then rapidly dropped his GCS to 8. The ambulance crew on scene have intubated him and whisk him into your emergency department.
During your primary survey, you noticed his left pupil is dilated and non-reactive.Read More