Case-Based Modules > Case 14 > Stage 5

The ED team intubates the patient. They perform RSI with etomidate and rocuronium. They get a grade 1 view with video laryngoscopy and have easy ETT passage. Propofol gtt is immediately started thereafter. You tell them they don't need to start fentanyl gtt. You admit them to the NCCU.

They're stable upon arrival to the NCCU. All convulsions had stopped. Particularly because this patient came in as a trauma activation and had lost consciousness, you re-scan his head. There's now subtle signs of mild diffuse cerebral edema. Neurosurgery places an intraparenchymal ICP monitor, which reveals ICPs in excess of 25mmHg. You're able to manage his intracranial hypertension with sedation and hyperosmolar therapies. You do get him connected to cEEG. You start a second ASM for him. After a lot of work, you're able to wean him off sedation over the next few days. He's extubated on day 6 of his ICU admission. He's ultimately discharged from the floor to inpatient rehab on day 12 of admission.

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