NCCEd: Neurocritical Care Education for Residents

You follow peripherally. Due to the patient's cardiac arrest and current serious clinical status, operative spine intervention is being deferred for the time being. Continuous EEG demonstrates a diffusely slow, disorganized background, with intermittent excess beta activity. There are no state changes or reactivity to stimuli, though the latter hasn't been directly formally assessed. He requires dopamine gtt to maintain his HR and BP.

It's now day 3 of admission. You're called back to reevaluate the patient. You ask the primary team to try and hold sedation if possible. On exam, he is unresponsive to voice and noxious stimuli. Pupils are equal at 3.5mm in diameter, round, and reactive, with NPI > 1.9 with quantitative pupillometry. He is riding the ventilator. He has no motor response to noxious stimuli in his extremities.