- 78.5k views
Management of Stroke in ICU
Rapid transfer of stroke patients to the ICU allows for immediate assessment and intervention.Continuous monitoring of vital signs, neurological status, and oxygen saturation is essential to detect changes promptly. Administration of clot-dissolving agents like tissue plasminogen activator (tPA) within the therapeutic window can restore blood flow in ischemic stroke patients. For large vessel occlusion, mechanical removal of the clot using catheter-based techniques can be performed in eligible patients. Maintain stable blood pressure and perfusion to the brain while avoiding extremes that might exacerbate cerebral edema or hemorrhage. Ensure proper airway management and oxygenation to prevent secondary brain injury. Frequent imaging (CT or MRI) monitors for changes in brain structure, blood flow, and response to treatment. Continuous ICP monitoring helps manage elevated pressure and prevent cerebral herniation.
About the Speaker
Dr Pooja Wadwa
Additional Director, Critical Care Medicine, ECMO specialist,FMRI, Gurgoan
Dr. Pooja is currently working as Additional Director at FMRI. She is a MD (Internal Medicine), Observership,in ICU Royal Melbourne Hospital, Australia. She completed Indian Diploma in Critical Care Medicine (IDCCM) FROM Indraprastha Apollo Hospitals, New Delhi
Upcoming CME Events
Overview on Symptom Assessment in Dialysis
Symptom assessment in dialysis is a critical aspect of managing patients with kidney failure undergoing renal replacement therapy. The evaluation includes monitoring common symptoms such as fatigue, nausea, itching, and fluid overload, which can significantly impact patients' quality of life. Regular assessment allows healthcare providers to tailor interventions, adjust dialysis prescriptions, and address underlying causes, ensuring optimal symptom management and improving the overall well-being of individuals undergoing dialysis.
Public Expectations and Misunderstandings About Critical Care
Public Expectations and Misunderstandings About Critical Care often revolve around the perception of medical interventions and outcomes in intensive care units (ICUs). Many people believe that advanced medical technologies and treatments can invariably save lives or fully restore health, underestimating the complexities and limitations of critical care. This misunderstanding is partly fueled by media portrayals of medicine, where recovery is often rapid and complete. In reality, critical care outcomes can vary greatly, with some patients experiencing long-term physical, cognitive, and psychological effects post-ICU. Additionally, there's a lack of awareness about the nature of end-of-life care in ICUs, leading to unrealistic expectations about the effectiveness of life-sustaining treatments. This gap in understanding underscores the need for better public education about the realities of critical care, the potential outcomes, and the importance of advance care planning.
ECHO & Ultrasound guided hemodynamic management in ICU
Bedside echocardiography (ECHO) and ultrasound play a crucial role in hemodynamic monitoring and management in the intensive care unit (ICU). They are non-invasive techniques, reducing the risks associated with invasive procedures while offering valuable insights into cardiac function. ECHO and ultrasound help evaluate intravascular volume, guiding the administration of fluids in critically ill patients to optimize cardiac output. These tools allow assessment of cardiac contractility, ejection fraction, and valvular function, aiding in the management of heart-related issues. ECHO and ultrasound are instrumental in diagnosing conditions like pericardial effusion, tamponade, cardiomyopathy, and structural heart defects in ICU patients. In some cases, ECHO and ultrasound can replace more invasive monitoring techniques, like pulmonary artery catheters, for hemodynamic data. They help monitor the effects of interventions, such as medication administration, fluid boluses, or mechanical ventilation adjustments. ECHO and ultrasound can guide procedures like central line placement, thoracentesis, or pericardiocentesis, reducing the risk of complications. ECHO and ultrasound allow evaluation of not only the heart but also other organs, including the lungs and abdomen, providing a comprehensive view of a patient's condition.
Role Played by ECMO in Critical Care
Extracorporeal Membrane Oxygenation (ECMO) plays a pivotal role in critical care, providing advanced life support for patients with severe cardiac or respiratory failure. By temporarily assuming the function of the heart and lungs, ECMO allows vital organs to recover, offering a crucial bridge to recovery or transplant. Its capacity to maintain oxygenation and circulation in critically ill patients underscores ECMO's significance as a lifesaving intervention in the intensive care setting.