A 45-year-old male presents to the emergency department with severe headache, vomiting, and altered mental status. His vital signs are: BP 180/100 mmHg, HR 55 bpm, RR 12/min, and SpO2 98% on room air. Which of the following interventions should be prioritized to manage this patient's suspected increased intracranial pressure?
The correct answer is to elevate the head of the bed to 30 degrees. This positioning helps to promote venous drainage from the brain, which can reduce intracranial pressure. It's important to note that while all the other options may be part of the management plan for increased ICP, they are not the immediate priority.
Administering mannitol is a second-line treatment and should only be done after consulting with neurosurgery. Intubation may be necessary if the patient's condition deteriorates, but it's not the first step. Administering IV fluids at this stage could potentially worsen the ICP by increasing cerebral blood volume.
Remember, the initial management of increased ICP focuses on optimizing cerebral perfusion pressure while minimizing factors that can exacerbate the pressure. Elevating the head of the bed is a simple yet effective intervention that can be implemented immediately upon suspicion of increased ICP.
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Neurological Emergencies
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