Hold IV Lidocaine if patient has liver dysfunction that may result in toxic levels. Cool as early and as rapidly as possible after the injury. Strict control of temperature should be maintained as long as the patient is being monitored and treated for cerebral edema and intra-cranial hypertension. Strict control of temperature should be maintained as long as the patient is being monitored and treated for cerebral edema and intra-cranial hypertension. Discontinue strict control of temperature in these patients when obstructive hydrocephalus appears to be the only cause of intra-cranial hypertension ie.
Cerebral edema is no longer a concern.
1st - Drain CSF for 5 minutes as needed. Record each episode of acute hyperventilation with bag and O2 in the flow sheet. Stat CT scan of head may be needed. When a decision is made by MDs that cerebral edema and intracranial hypertension are resolving and therapies are being weaned and discontinued one at a time, thresholds for treatment of ICP and CPP may be liberalized according to MD orders.