Justin Wang, Lee Pei Chuen
- To know the general management of paediatric traumatic brain injury in ICU
- To diagnose raised intracranial pressure in paediatric traumatic brain injury
- To know how to manage acute raised intracranial pressure based on current recommendations.
Synopsis of PBLD:
A one-month-old baby girl was lying on her mother’s lap in the front passenger seat of a car. Their car was hit by another vehicle. Both mother and the baby were thrown out of their car as her mother was not wearing a seat belt. The baby was resuscitated in the emergency department. She sustained multiple abrasions and CT brain revealed left parietal subarachnoid haemorrhage with intraventricular extension. She underwent craniotomy for evacuation of the haematoma and returned to Paediatric ICU (PICU) after surgery. Upon arrival to PICU, her heart rate was 183 bpm and blood pressure 73/32mmHg. An hour later, her pupils were noted to be unequal. Blood pressure at that time was 148/84 mmHg with a heart rate of 70 bpm. What is going on in this child?
The highlight of the discussion will be on the general management of post-neurosurgical patients with traumatic brain injury in ICU.