title: Emergency neurological life support: intracranial hypertension and herniation.
abstract: Sustained intracranial hypertension and acute brain herniation are "brain codes," signifying catastrophic neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, evidence supports the organized implementation of a stepwise management algorithm. Because there are multiple etiologies and many treatments that can potentially reverse cerebral herniation, intracranial hypertension and herniation was chosen as an Emergency Neurological Life Support (ENLS) protocol.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Stevens
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Huff
authors.forename: Josh
authors.initials: J
authors.lastname: Duckworth
authors.forename: Alexander
authors.initials: A
authors.lastname: Papangelou
authors.forename: Scott D
authors.initials: SD
authors.lastname: Weingart
authors.forename: Wade S
authors.initials: WS
authors.lastname: Smith
mesh_terms: D000465:Algorithms; D056424:Decompressive Craniectomy; D004234:Diuretics, Osmotic / Q000627:therapeutic use*; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology / Q000628:therapy*; D008353:Mannitol / Q000627:therapeutic use; D019635:Neurosurgical Procedures / Q000379:methods*; D017410:Practice Guidelines as Topic; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D014696:Ventriculostomy / Q000379:methods
chemical_list: D004234:Diuretics, Osmotic; D012462:Saline Solution, Hypertonic; D008353:Mannitol