Critical Care Scenarios Episode 14: Intracerebral hemorrhage and elevated ICP (part 2)
Aug 23, 2020
Delve into the intricacies of managing intracerebral hemorrhage and the emotional challenges faced by caregivers. Discover the complexities of communicating prognosis and treatment plans to families. Learn about vital neurological assessments and the nuances of tracheostomy decisions in neuro recovery. Explore how emotional factors can impact critical care decisions while emphasizing the need for realistic expectations. The discussion highlights the importance of multidisciplinary collaboration and effective family communication throughout the recovery process.
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Neurological Examination Techniques
- Assess neurological exam by addressing patients verbally and observing their response to stimuli.
- Employ central painful stimuli like a pec pinch, and check for localization or withdrawal.
Common Misinterpretations in Neurological Exams
- Triple flexion (flexion at hip, knee, and ankle) is a spinal reflex, not a withdrawal response.
- Squeezing hands can be reflexive, not necessarily a sign of following commands.
Reliable Commands for Neurological Assessment
- Avoid "squeeze my hand" as a command, as it can be reflexive.
- Use "show me your thumb" or "show me two fingers" for clearer assessment.