unusual case

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He needs an ICP monitor (can be done at the bedside) and a formal
angiogram [or angiogram first if there is going to be a delay getting
the ICP monitor]. Good standard neurointensive care (sedation,
ventilation to normocarbia, STABLE blood pressure (not too low and not
too high), normal electrolytes, euvolaemia)

Please show us the angiogram!

Cheers, Ian

correspondence to: seppelt at med.usyd.edu.au

Ian Seppelt FANZCA FJFICM
Senior Staff Specialist
Dept of Intensive Care Medicine
The Nepean Hospital, PO Box 63 Penrith NSW 2751
Director of Clinical Research, Sydney West AHS
Clinical Lecturer, University of Sydney

>>> danielsimonster at gmail.com 05/02/08 1:29 am >>>
43 year old motorcycle crash victim , on scene intubation for GCS of 5.
On
admission intubated and ventilated, B.P 130/80 P 82 sat 100% , GCS 7
(T) .
PE: skin lacerations and  central hematoma anterior neck - zone 1.
Head CT - SAH, Frontal contusions,small Frontal SDH, many skull
fractures.
C-spine:  fracture of C1
Chest XR and relevant cuts from the chest  CTA included.
Abdominal CT normal
What would you do now?

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