Management of the severely head injured patient.
The care of the severely brain injured patient presents important challenges to the anesthesiologist. The patients are often young, there is little time for preparation, there are associated injuries, the airway management may be difficult or risky to the brain or spinal cord, the outcome varies widely and it is not always possible to monitor the desired physiological variables. Furthermore, there is no single intervention or agent that has emerged as being beneficial, but the degree to which care is taken in the domain of the anesthesiologist, will have an important impact on outcome. The central themes in patient care include rapid attention to resuscitation and maintenance of adequate CPP and oxygen delivery. Careful attention to post-operative care will also affect outcome. Recognizing that the outcome may not be determined solely at the time of impact is an important concept for all who take care of these patients.
Baker
A J
AJ
Department of Anaesthesia, University of Toronto, ON. bakera@smh.toronto.on.ca
D000758:Anesthesia; D006259:Craniocerebral Trauma / Q000601:surgery / Q000628:therapy*; D003422:Critical Care; D006801:Humans; D012151:Resuscitation