In this post I link to and excerpt from EMCrit 275 – NeuroCritical Care with Neha Dangayach. by
Note to myself: The show notes, which I’ve excerpted below are outstanding. However, the podcast itself should be reviewed over and over. The lecture has much more than just the great show notes.
Radiopaedia.org is an outstanding source of information on neurology and neurocritical care.
All that follows is from the above podcast and show notes.
Video the CT with phone
2 person job
scroll through every image of axial head ct q 2 seconds
Scroll through CTA MIPs, axial and coronal (sag is a bonus)
Specify how often to cycle BP cuff
Who to Intubate and Neuroprotective Intubation
Which Osmotic Agent for ICP
Recent paper shows no benefit from PLTs or dDAVP in non-neurosurg bleeds [10.1097/CCM.0000000000004348]
Choice of 2nd Line Agent
Keppra 60mg/kg (1/2 the dose in ESRD)
General Anesthetic of Choice is Midazolam
0.2 mg/kg bolus
start infusion 0.2 mg/kg/hr
titrate up every 5 minutes
max 2.9 mg/kg/hr
when getting close to 1mg/kg/hr, give ketamine 1mg/kg followed by 1 mg/kg/hr
Cirrhotics, get propofol