NEUROQBANK

Announcements: Neuromuscular section updated with more questions.

CHILL ALERT: called for patients who suffer cardiac arrest and meet a number of criteria to undergo cooling to decrease the degree of neurologic injury.  Neurology is paged on the stroke alert pager and should respond immediately.

Protocol:

  • Examine patient. Patient should be comatose, GCS < 8. Patients who are waking up are not likely to require hypothermia. When in doubt, call the on-call hypothermia attending
  • Obtain non-contrast head CT if possible, r/o ICH
  • Obtain emergent portable EEG # 1 during hypothermia (core temperature 32-34 degrees Celsius)

Document in your note:

  • date / time of initial arrest (if known)
  • time to CPR
  • date / time of Restoration Of Spontaneous Circulation (ROSC)
  • date / time of arrival in the hospital
  • date / time of your neurologic exam and whether patient is on sedating or neuromuscular blockade agents and whether they are intubated
  • coma exam (please refer to coma exam under Common Consults section)
  • In your assessment and plan, please include the Arctic Sun EEG Protocol

Phase I (initiation of cooling), day 1: EEG (portable, to be done in ICU)

Phase II (rewarming), day 2: EEG (portable)

Phase II (rewarmed), day 3: EEG at temperature >36C normal core body temperature

If non-convulsive status epilepticus is suspected, then please call neurology to obtain emergent portable EEG

Powered by liveSite