Page 150 - Critical Care Notes

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NEURO
■ Provide DVT and stress ulcer prophylaxis.
■ Prepare patient and family for possible decompression craniectomy.
■ The following can ↑ ICP and should be avoided: hypercapnia, hypoxemia,
Valsalva maneuver, isometric muscle contractions, REM sleep, and noxious
stimuli.
Glasgow Coma Scale

Response Patient Response Score Patient A Patient B
Eye opening Spontaneous 4
response To voice 3
To pain 2
None 1
Best verbal Oriented 5
response Confused 4
Inappropriate words 3
Incomprehensible 2
sounds
None 1
Best motor Obeys command 6
response Localizes pain 5
Withdraws 4
Flexion 3
Extension 2
None 1
Total 3–15
A score of 8 or less indicates severe head injury.
Reprinted from Teasdale, G., and Jennett, B.: Assessment of coma and impaired consciousness:
A practical scale. Lancet 304:4, 1994. Copyright 1994, with permission from Elsevier.
Full Outline of UnResponsiveness Score
(FOUR Score)

Eye Response Findings Score
Eyelids open and tracking, or 4
blinking on command
Eyelids open but not tracking 3
Continued
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