<< Therapeutic Uses Of Hypertonic Saline In The Critically Ill Emergency Department Patient (Trauma CME)

Must-Do Markers Of Quality Care

TOC Will Appear Here

  • Avoid secondary brain injury caused by hypotension and hypoxia.
  • Reduce ICP and maximize CPP by using head of bed elevation, supporting SBP > 90 mm Hg, preventing hypoxia, and using normocapnic ventilation.
  • Administer osmotic agents to patients with signs of impending herniation (asymmetric pupillary response, dilated and unreactive pupils, motor posturing, or rapid neurologic decline).
  • Recognize neurologic signs of cerebral edema secondary to hyponatremia (seizures, encephalopathy, or focal neurologic signs).
  • Do not try to correct the patient’s serum sodium level to “normal” values.
  • Avoid overcorrection of chronic hyponatremia or undercorrection of acute symptomatic hyponatremia, as these can lead to serious neurologic injury.
  • Do not increase a patient’s serum sodium by more than 10 to 12 mEq/L/d, as this may precipitate ODS.
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