Podcast 78 – Increased Intra-Cranial Pressure (ICP) and Herniation, aka Brain Code - a podcast by Scott D. Weingart, MD FCCM

Today we are going to discuss increased intracranial pressure (ICP) and herniation. This is the first of 13 lectures to go with the upcoming Emergency Neurological Life Support Course that I co-chair.

Screen for Increased Intracranial Pressure

Matt & Mike's Ultrasound Podcast on Ocular Ultrasound

Tier 0

Head of Bed Up



Temp Normal



PaCO2 35-38 mm Hg



Control Pain/Sedate if Intubated

Tier 1

Osmotic Therapy



Mannitol



Hypertonic Saline



Sodium Bicarb

Tier 2

Propofol (or Phenobarb) Drip titrated to take patient to low levels of sedation scales (5-200 mcg/kg/min)



CPP Optimization

Tier 3

Decompressive Craniectomy



Induced Hypothermia



Pentobarb



Moderate Hyperventialtion (I reserve for patients who are herniating)

Want more Tier 3 therapies?

Get Thomas Scalea's Lecture on TBI/ICP



* Already a EMCrit CME Member, go to the CME Learning Site.

* Want to become a member? Go to the CME Signup Page.

* Are you in-training in a medical profession, go to the EMCrit In-Training Page.



Now, on to the podcast...

Further episodes of EMCrit Podcast

Further podcasts by Scott D. Weingart, MD FCCM

Website of Scott D. Weingart, MD FCCM