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This patient is unable to protect her airway due to a reduced level of consciousness and loss of pharyngeal muscle tone. In addition, she will need ventilatory control to prevent hypercapnia, which would lead to rises in intracranial pressure.
The hypertension is a physiological response to brain injury and raised intracranial pressure caused by direct stimulation of the vasomotor centres. This leads to an increase in vasomotor tone and so hypertension. This may be accompanied by a baroreceptor-mediated bradycardia - the classical Cushing's response to raised intracranial pressure. |
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While this patient undoubtedly requires a CT scan of her brain prior to further therapy, her airway must be protected and secondary brain injury minimised before progressing to CT scanning.