unusual case

[Ian Seppelt]

He needs an ICP monitor (can be done at the bedside) and a formal
angiogram [or angiogram first if there is going to be a delay getting
the ICP monitor]. Good standard neurointensive care (sedation,
ventilation to normocarbia, STABLE blood pressure (not too low and not
too high), normal electrolytes, euvolaemia)

Please show us the angiogram!

Cheers, Ian

correspondence to: seppelt at med.usyd.edu.au

Ian Seppelt FANZCA FJFICM
Senior Staff Specialist
Dept of Intensive Care Medicine
The Nepean Hospital, PO Box 63 Penrith NSW 2751
Director of Clinical Research, Sydney West AHS
Clinical Lecturer, University of Sydney

>>> danielsimonster at gmail.com 05/02/08 1:29 am >>>
43 year old motorcycle crash victim , on scene intubation for GCS of 5.
On
admission intubated and ventilated, B.P 130/80 P 82 sat 100% , GCS 7
(T) .
PE: skin lacerations and  central hematoma anterior neck - zone 1.
Head CT - SAH, Frontal contusions,small Frontal SDH, many skull
fractures.
C-spine:  fracture of C1
Chest XR and relevant cuts from the chest  CTA included.
Abdominal CT normal
What would you do now?

______________________________________________________________________________

This electronic message and any attachments may be confidential.  If you
are not the intended recipient of this message would you please delete the
message and any attachments and advise the sender. Sydney West
Area Health Service (SWAHS) uses virus scanning software but excludes 
any liability for viruses contained in any email or attachment.

This email may contain privileged and confidential information intended
only for the use of the addressees named above. If you are not the
intended recipient of this email, you are hereby notified that any use,
dissemination, distribution, or reproduction of this email is prohibited. If
you have received this email in error, please notify SWAHS
immediately. 

Any views expressed in this email are those of the individual sender 
except where the sender expressly and with authority states them 
to be the views of SWAHS.