Raised IntraCranial Pressure (ICP)

🔑 Key Priorities

  • Maintain cerebral perfusion pressure

  • Prevent secondary brain injury

🧠 Team Actions

Role

Task

Team Leader

Direct BP and sedation targets

Airway Manager

Control CO₂, oxygenation

Circulation

Maintain MAP, avoid hypotension

🧭 Management Algorithm

  1. Elevate head 30° (neutral neck)

  2. Ensure SpO₂ > 94%, PaCO₂ ~35 mmHg

  3. Maintain MAP for CPP > 60 mmHg

  4. Sedation ± paralysis to prevent coughing/movement

  5. Osmotherapy:

    • Mannitol 0.25–1 g/kg IV OR

    • Hypertonic saline 3% (2–5 mL/kg)

  6. Avoid hypo/hyperglycaemia

  7. Discuss early with neurosurgery ± ICU

🔄 Ideal Crisis Flow

       Suspected Raised ICP
              ↓
     Elevate Head, Ensure O₂/CO₂
              ↓
       Sedate + Osmotherapy PRN
              ↓
       Maintain CPP, Avoid Secondary Hits

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