ONLY FOR DOCTORS
These are pretty self-explanatory. Remember that a sick brain is more sensitive to the effects of metabolic perturbations, so these should be sought and aggressively treated.
. Mild fever or changes in sodium or glucose may have an exaggerated clinical effect.
. Any intercurrent infection such as urinary tract infection or pneumonia will magnify the neurologic findings.
. Reduced cardiac output is a particularly bad co morbidity resulting in worse clinical outcome, and should be carefully avoided by optimizing fluid and inotropic therapy.
. Remember also that ‘‘if the lips are blue, the brain is too,’’ so look for, determine the cause of, and treat arterial oxygen desaturation.
Possible causes:
– Pulmonary embolism
– Pneumonia
– Pulmonary edema
. Anemia: transfuse for hemoglobin <10 g.
. Sedative drugs interfere with rapid transition to rehabilitation mode and have also been associated with worse outcome, decreased mobilization with attendant increased DVT, etc. Sedating drugs should be avoided as far as possible.
