People are admitted to the ICU (Intensive care unit) due to various reasons. They are all critically ill people who need continuous care, support and monitoring. Out of these people, some are brought to the hospital when they are still conscious. They may be having difficulty in walking, talking and doing things, but they are still conscious. For example, people with head injury. But, after surgery, they are brought to the ICU and they remain unconscious for days.
Some times this is not because they are actually unconscious. Sometimes they are unconscious because they are made unconscious. Now, you might think why? To understand this you should know what happens in head injury and after surgery.
If we take a brain hemorrhage, that is bleeding in side the brain, there is accumulation of blood and edema fluid within the skull. As the brain is in a confined cavity, the brain tissue gets compressed and herniated. If the pressure goes very high, the herniation can even cause death. Therefore the anaestherists take measures to reduce further brain edema. Meanwhile they should also prevent further brain damage by maintaining good blood flow to the brain.
The measures they take to achieve these targets involves 2 kinds of actions.
- Brain protection by maintaining -
- normal oxygen level
- normal carbon dioxide level
- normal pressure
- normal glucose level
- normal temperature
- normal blood volume
- Brain relaxation by –
- Sedation
- Paralyzing and ventilation
- Giving antiepileptics
- Positioning the patient in 200 angle
- Neutral position of the neck and head
- Flexing the hip
As you can see the some of the above measures includes sedation and paralysis. The artificial ventilation also needs the patient to be in an inhibited state, so he/she won’t feel the uncomfortable instruments that are put in to their throats.
As their conditions gradually starts to improve, the anaesthetists will slowly reduce the sedating drugs and make the patient able to talk. Then he/she is fit enough to go to a ward and get treatments.
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