Case Presentation
This section of the paper focuses on a 24 years old Caucasian male who was transferred to Advocate Christ Medical Center from an outside hospital after being hit by a vehicle. According to the EMS who arrived at the scene, the patient was unresponsive with a GCS of 3. Per protocol, the patient was then intubated to sustain their airway. The patient received a CT of the head that revealed bifrontal and bitemporal hemorrhagic contusions along with multiple facial fractures. The patient was admitted to the surgical trauma ICU to receive treatment.
Patient History The patient had no significant medical history prior to being admitted into the ICU, however, he did have a psychological history of depression and anxiety. There …show more content…
The diagnosis of traumatic brain injury is one that affects multiple body systems. Following brain trauma, hypothalamic stimulation of the sympathetic nervous system causes the release of catecholamines (Lemke, 2007). These catecholamines elevate metabolic rate and as a result can lead to hypertension as a compensatory mechanism to increase perfusion to the brain. During the patient’s first day at the surgical trauma ICU, his systolic blood pressure ranged between the 140s and160’s with a diastolic range of 60 to 99. Similarly, his mean arterial pressures (MAPs) were ranging from low 80s to high 90s. Subsequent to the prolonged hypertension, the patient has the potential for cardiac dysfunction due to the increase stress on the heart (Lemke, 2007). If the fluid shift, caused by these circulating catecholamines, overloads the pulmonary system then neurogenic pulmonary edema can happen resultantly. Another effect of catecholamines is hyperthermia and potential hyponatremia if diaphoresis ensues. The patient exhibited an increasing temperature throughout the shift. The temperature started at 37.2 and crept up as high as 38.9 degrees Celsius. Other effects of the stress response caused by the injured brain are: hyperglycemia, renal insufficiency, muscle wasting, and weight loss (Lemke,
This section of the paper focuses on a 24 years old Caucasian male who was transferred to Advocate Christ Medical Center from an outside hospital after being hit by a vehicle. According to the EMS who arrived at the scene, the patient was unresponsive with a GCS of 3. Per protocol, the patient was then intubated to sustain their airway. The patient received a CT of the head that revealed bifrontal and bitemporal hemorrhagic contusions along with multiple facial fractures. The patient was admitted to the surgical trauma ICU to receive treatment.
Patient History The patient had no significant medical history prior to being admitted into the ICU, however, he did have a psychological history of depression and anxiety. There …show more content…
The diagnosis of traumatic brain injury is one that affects multiple body systems. Following brain trauma, hypothalamic stimulation of the sympathetic nervous system causes the release of catecholamines (Lemke, 2007). These catecholamines elevate metabolic rate and as a result can lead to hypertension as a compensatory mechanism to increase perfusion to the brain. During the patient’s first day at the surgical trauma ICU, his systolic blood pressure ranged between the 140s and160’s with a diastolic range of 60 to 99. Similarly, his mean arterial pressures (MAPs) were ranging from low 80s to high 90s. Subsequent to the prolonged hypertension, the patient has the potential for cardiac dysfunction due to the increase stress on the heart (Lemke, 2007). If the fluid shift, caused by these circulating catecholamines, overloads the pulmonary system then neurogenic pulmonary edema can happen resultantly. Another effect of catecholamines is hyperthermia and potential hyponatremia if diaphoresis ensues. The patient exhibited an increasing temperature throughout the shift. The temperature started at 37.2 and crept up as high as 38.9 degrees Celsius. Other effects of the stress response caused by the injured brain are: hyperglycemia, renal insufficiency, muscle wasting, and weight loss (Lemke,