Title: Intubating the Neurologically Injured Patient<br/>Author: Danya Khoujah<br/><a href='http://umem.org/profiles/faculty/739/'>[Click to email author]</a><hr/><p>
<span style="font-family: arial, sans-serif; font-size: 12.8px;">Airway management is an integral part of caring of critically ill patients, but is there anything that should be done differently in the neurologically injured patient?</span></p>
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<span style="font-family: arial, sans-serif; font-size: 12.8px;">Injured brains are particularly sensitive to hypoxia. Avoid it by appropriate positioning and preoxygenation.</span></li>
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<span style="font-family: arial, sans-serif; font-size: 12.8px;">Consider fentanyl and/or ketamine for sedation for RSI, as fentanyl can blunt the hemodynamic response to intubation, while ketamine is hemodynamically neutral and safe.</span></li>
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<span style="font-family: arial, sans-serif; font-size: 12.8px;">Consider Esmolol (1.5mg/kg) prior to intubation to prevent sympathomimetic surge during intubation in the absence of multiple injuries.</span></li>
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<span style="font-family: arial, sans-serif; font-size: 12.8px;">There is no role for the use of a defasciculating dose of neuromuscuclar blockade during RSI</span></li>
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<fieldset><legend>References</legend>
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Bucher J, Koyfman A. <strong>Intubation of the Neurologically Injured Patient. </strong>JEM 49 (6) 920-7</p>
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