What is a subarachnoid haemorrhage

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Reference no: EM132392523 , Length: word count : 2000

Assignment

Part A: Consider the vital signs and symptoms in the tutorial cases of Leo (aSAH) and Tamara (Paediatric MTBI) while in the emergency department.

Which vital signs and symptoms and are indicative of suspected rising intracranial pressure? Explain the pathophysiology of the chosen signs and symptoms applying the concepts to the surveillance of neurological deterioration in each case.

Use these headings/sections:

1.Define intracranial pressure and its pathophysiology (relate to SAH and MTBI)

2. Signs and Symptoms related to rising ICP (and pathophysiology)

3. Do Leo and Tamara exhibit these Signs and Symptoms (explain why)

4. First-line management to prevent deterioration in both Leo and Tamara

Part B: What is the role of the family in the recognition of deterioration and escalation of care in these tutorial cases? Explain using published evidence.

Refer to the Australian Commission on Safety and Quality on Healthcare - standard nine: recognising and responding to clinical deterioration in acute healthcare implementing recognition and response systems -Escalation of care.

The escalation protocol should allow for the concerns of the patient, family or carer to trigger an escalation of care.

Questions

1. What is a subarachnoid haemorrhage? What is the significance of the Hunt- Hess score of III?

2. Explain the concept of rising intracranial pressure in relation to Cushings triad. What raises intracranial pressure in a SAH?

3. Comment on the neurological examination findings in the ED.

4. Explain how you would manage a tonic-clonic seizure?

5. What is the basis to the ECG changes and the positive Troponin T levels in SAH?

6. Why was Nimodipine prescribed? What needs to be closely watched when administering it as an IV infusion?

7. Outline the management of the intraventricular EVD drain.

8. What is the importance of adequate oxygenation in brain injury?

9. Why is the end tidal CO2 being closely monitored?

10. What is the significance of a stable blood glucose level between 6.1 and 10 mmol/L in neurological patients?

11. What is the optimum body temperature in patients with neurological injury. 12.Triple H therapy (Hypervolaemia, hypertension, and haemodilution) has now been dropped as a recommendation in the new SAH guidelines. However, hypertension and eurovolemia are now recommended. What is the basis to these recommendations?

13. What is Delayed Cerebral lschemia? What is vasospasm?

14. Comment and analyse the management on Day 3 in the ICU.

Attachment:- Neurological Dysfunction.rar

Reference no: EM132392523

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