Mods Emergency 4 Edicion Oro [REPACK]
management of tbi patients with an intracranial haemorrhage (ich) is a major challenge because of the frequent associated co-morbidities and the limited access to neurosurgery. the american college of emergency physicians (acep) suggest that the use of anticoagulant or antiplatelet drugs should be considered if the inr is >1.5 or if there is clinical evidence of a coagulopathy such as petechiae, purpura, or melena, and if apa or anticoagulant therapy is to be used to prevent stroke [ 170 ]. in these patients, the factors that influence the decision to initiate anticoagulation therapy include the severity of injury, the presence or absence of intracranial haemorrhage, the use of tbi, and the presence of other co-morbidities [ 171 ]. in cases where anticoagulants are not indicated, such as bleeding trauma in younger patients without thromboembolic or haemorrhagic risk factors, or in those with minor head injury with signs of intracranial bleeding and a good neurological recovery, it has been suggested that antiplatelet treatment with aspirin or clopidogrel is a reasonable treatment option [ 172 ].
Mods Emergency 4 Edicion Oro
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the 2019 acscot guidelines offer an evidence-based update to the existing guidelines. this guideline is the first in the field of critical care to be updated since the publication of the 2002 guidelines in an attempt to make critical care practice more consistent and efficient. the recommendations are organized according to the following 5 sections: focused clinical questions, clinical pearls, emergency management, disaster management, and clinical research. this article reviews the recommendations pertaining to our focus of interest, intracranial pressure (icp) management.