What is the best next step in management for a patient presented to ER after a fall, intubated due to deterioration, with a unilateral dilated pupil and suspected basal skull fract... What is the best next step in management for a patient presented to ER after a fall, intubated due to deterioration, with a unilateral dilated pupil and suspected basal skull fracture? A- Hyperventilation B- Mannitol Infusion C- Elevate head from side.
Understand the Problem
The question is asking for the best next step in the management of a patient who has suffered a fall, has a unilateral dilated pupil, and is suspected to have a basal skull fracture. It presents multiple management options, and we need to determine which one would be the most appropriate based on the clinical scenario.
Answer
Mannitol Infusion.
Mannitol Infusion.
Answer for screen readers
Mannitol Infusion.
More Information
Mannitol infusion is commonly used to reduce intracranial pressure. In the context of a traumatic brain injury with signs of herniation (such as unilateral dilated pupil), mannitol is often the best immediate intervention.
Tips
A common mistake is using prophylactic hyperventilation too early. It should be avoided unless there are clear signs of herniation, as it can reduce cerebral blood flow.
Sources
- Traumatic Brain Injury (TBI) - Merck Manuals - merckmanuals.com
- New Concepts in Treatment of Pediatric Traumatic Brain Injury - PMC - pmc.ncbi.nlm.nih.gov
AI-generated content may contain errors. Please verify critical information
