Podcast # 484: Elevated ICP

Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma.

While definite treatment is to remove the offending cause, there are emergency medicine

Non-pharmacologic methods include elevating head of bed and removing noxious stimuli

Pharmacologic options include mannitol and hypertonic saline

Hypertonic saline is best delivered through a central line but not required

Both these agents benefit from adequate renal function

Before using mannitol, be sure to inspect the bag to ensure that it has not precipitated. If it has, try warming the bag before administration.