Neuro ICU Procedure Atlas

 

Description:

Atlas provides insightful guidance on how to perform core procedures in the neuro ICU

Neuro ICU Procedure Atlas by distinguished neurosurgeons Jack I. Jallo and David F. Slottje is a visually rich, step-by-step atlas describing technical aspects of common bedside procedures performed in patients with grave neurological conditions. With contributions from an impressive group of contributors, the book features 13 chapters encompassing fundamental techniques, such as shunt externalization/shunt tap, lumbar puncture, lumbar drain, ICP monitor, PbtO₂ and JvO₂ monitors, central and arterial line, cervical traction, intubation, cricothyrotomy, chest tube, and more.

Key Highlights:

In-depth, reader friendly discussion of vital clinical issues including indications and contraindications, relevant anatomy/physiology, and complications

Clinical pearls and troubleshooting sections for each approach

Illustrations of ventricular drain or ICP monitor placement, non-conventional ventricular drain insertion points, trajectory lines for ventricular drain insertion, and more provide detailed visual learning guides

This essential resource will help neurosurgical residents and early-career neurosurgeons, intensivists, nurse practitioners, and physician assistants accelerate the learning curve for the bedside care of critically ill patients.

 

 

Table of Contents:

 

 

 

1 External Ventricular Drain

 

1.1 Introduction

1.2 Relevant Anatomy and Physiology

1.3 Indications

1.3.1 ICP Monitoring

1.3.2 CSF Diversion

1.3.3 Intrathecal Access

1.4 Contraindications

1.4.1 Special Situations

1.5 Equipment

1.6 Technique

1.6.1 Preparation

1.6.2 Medications

1.6.3 Positioning/Equipment Setup

1.6.4 Procedure

1.6.5 Alternative Approaches

1.7 Complications

1.7.1 Infection

1.7.2 Hemorrhage

1.7.3 Upward Herniation

1.7.4 Aneurysm Re-rupture

1.7.5 Motor Cortex Injury

1.7.6 Superior Sagittal Sinus Injury

1.8 Expert Suggestions/Troubleshooting

1.8.1 Scalp Bleeding

1.8.2 Entry Site

1.8.3 Tunneling Direction

1.8.4 Fracture Lines/Cranial Defects

1.8.5 Ventricular Collapse

2 Shunt Tap and Shunt Externalization

2.1 Introduction

2.2 Relevant Anatomy and Physiology

2.3 Indications—Shunt Tap

2.4 Contraindications—Shunt Tap

2.5 Equipment—Shunt Tap

2.6 Technique—Shunt Tap

2.6.1 Preparation

2.6.2 Medications

2.6.3 Positioning/Equipment Setup

2.6.4 Procedure

2.7 Indications—Shunt Externalization

2.8 Contraindications—Shunt Externalization

2.9 Equipment—Shunt Externalization

2.10 Technique—Shunt Externalization

2.10.1 Preparation

2.10.2 Medications

2.10.3 Positioning/Equipment Setup

2.10.4 Procedure

2.11 Complications

2.11.1 Infection

2.11.2 Catheter Retraction

2.11.3 Air Lock of Shunt System

2.12 Expert Suggestions/Troubleshooting

2.12.1 Inability to Tap Shunt Valve

2.12.2 Distal Catheter Resistance

2.12.3 Partial Retraction of the Shunt Catheter

3 Lumbar Puncture

3.1 Introduction

3.2 Relevant Anatomy

3.2.1 Cerebrospinal Fluid

3.2.2 Lumbar Spine

3.3 Indications

3.3.1 Obtain a CSF Sample

3.3.2 Measure Pressure

3.3.3 Therapeutic Drainage

3.4 Contraindications

3.4.1 Intracranial Space-Occupying Lesion or Existing Brain Shift

3.4.2 Obstructive Hydrocephalus

3.4.3 Coagulopathy/Clotting Dysfunction/Bleeding Disorder

3.4.4 Insertion Site Infection

3.5 Equipment

3.6 Technique

3.6.1 Patient Positioning

3.6.2 Preparation

3.6.3 Needle Insertion

3.6.4 Pressure Measurement

3.6.5 CSF Collection

3.6.6 Closure

3.7 Complications

3.8 Expert Suggestions/Troubleshooting

4 Lumbar Drain

4.1 Introduction

4.2 Relevant Anatomy/Physiology

4.3 Indications

4.3.1 Craniotomy

4.3.2 Endoscopic Skull Base Surgery

4.3.3 CSF Leak

4.3.4 Normal Pressure Hydrocephalus

4.3.5 Thoracoabdominal Aortic Surgery

4.3.6 Miscellaneous

4.4 Contraindications

4.4.1 Intracranial Mass Lesion

4.4.2 Obstructive Hydrocephalus

4.4.3 Skin Infection/Spinal Epidural Abscess

4.4.4 Coagulopathy/Thrombocytopenia/Anticoagulant Therapy

4.5 Equipment

4.6 Technique

4.6.1 Positioning and Equipment Setup

4.6.2 Procedure

4.7 Complications

4.7.1 Headache

4.7.2 Cerebral Herniation

4.7.3 Infection

4.7.4 Retained Catheter

4.7.5 Spinal Cord Injury/Parethesia

4.8 Expert Suggestions/Troubleshooting

4.8.1 Overdrainage

4.8.2 Catheter Shearing

4.8.3 No CSF Egress

4.8.4 Severe Pre-existing CSF Leak

4.9 Conclusion

5 Parenchymal Intracranial Pressure Monitor

5.1 Introduction

5.2 Relevant Anatomy and Physiology

5.3 Indications

5.3.1 Recommendations from the 4th Edition Brain Trauma Foundation Guidelines

5.3.2 Recommendations from the Prior (3rd) Edition Not Supported by Evidence Meeting Current Standards

5.4 Contraindications

5.5 Equipment

5.6 Technique

5.6.1 Preparation

5.6.2 Medications

5.6.3 Positioning/Equipment Setup

5.6.4 Procedure

5.6.5 Postprocedure

5.7 Complications

5.7.1 Infection

5.7.2 Hemorrhage

5.7.3 Motor Cortex Injury

5.7.4 Superior Sagittal Sinus Injury

5.8 Expert Suggestions/Troubleshooting

5.8.1 Scalp Bleeding

5.8.2 Entry Site

5.8.3 Aberrant ICP Measurement

6 Brain Tissue Oxygenation: Procedural Steps and Clinical Utility

6.1 Introduction

6.2 Relevant Anatomy and Physiology

6.2.1 Anatomic Considerations

6.2.2 Physiologic Principles

6.2.3 Devices

6.3 Indications

6.4 Contraindications

6.5 Equipment

6.5.1 Pre-Op Checklist and Equipment/Supplies

6.5.2 Sedation

6.6 Technique

6.6.1 Positioning

6.6.2 Incision Planning

6.6.3 Prep and Drape

6.6.4 Incision and Twist Drill

6.6.5 Dural Opening

6.6.6 Probe Placement and Securement

6.6.7 Connection to Monitoring System

6.6.8 Closure and Dressing

6.6.9 Postprocedure Imaging

6.7 Complications

6.7.1 Hemorrhage

6.7.2 CSF Leak

6.7.3 Skull Fracture

6.7.4 Infection

6.8 Expert Suggestions/Troubleshooting

6.8.1 Sedation Issues

6.8.2 Positioning Issues and Tips

6.8.3 Scalp Bleeding and Avoidance

6.8.4 Craniotomy Angulation and Tips

6.8.5 Dural Opening

6.8.6 Probe Pull-Out and Avoidance

6.9 Conclusion

7 Jugular Bulb Oxygen Monitor

7.1 Introduction

7.2 Relevant Anatomy and Physiology

7.3 Indications

7.4 Contraindications

7.5 Equipment

7.6 Technique

7.7 Complications

7.8 Expert Suggestions/Troubleshooting

8 Central Line

8.1 Introduction

8.2 Anatomy/Physiology

8.2.1 Subclavian Vein Anatomy

8.2.2 Internal Jugular Vein Anatomy

8.2.3 Femoral Vein Anatomy

8.3 Indications

8.4 Contraindications

8.5 Equipment

8.5.1 Catheter Types

8.6 Technique

8.6.1 Subclavian Vein Technique

8.6.2 Femoral Vein Technique

8.6.3 Internal Jugular Vein Technique

8.7 Complications

8.8 Expert Suggestions/Troubleshooting

9 Arterial Line

9.1 Introduction

9.2 Anatomy/Physiology

9.3 Indications

9.3.1 Measurement of Intra-arterial Blood Pressure

9.3.2 Arterial Access for Frequent Blood Sampling

9.4 Contraindications

9.5 Equipment

9.6 Technique

9.7 Complications

9.8 Expert Suggestions/Troubleshooting

10 Cervical Traction

10.1 Introduction

10.2 Relevant Anatomy and Physiology

10.2.1 Cervical Spine Anatomy

10.2.2 Pathophysiology of Cervical Traction

10.3 Indications

10.3.1 Facet Dislocations

10.3.2 Displaced or Angulated Hangman’s Fractures

10.3.3 Displaced or Angulated Type II Odontoid Fractures

10.3.4 Rotary Atlantoaxial Subluxations

10.3.5 Subaxial Burst Fractures

10.4 Contraindications

10.5 Equipment

10.5.1 Gardner-Wells Tongs

10.5.2 Halo Ring

10.5.3 Modified Hospital Bed

10.5.4 Weight

10.5.5 Halo Vest

10.6 Technique

10.6.1 Patient Assessment

10.6.2 Tong Placement

10.6.3 Patient Positioning

10.6.4 Weight Application

10.6.5 Neurological Monitoring

10.6.6 Radiographic Assessment

10.7 Complications

10.8 Expert Suggestions/Troubleshooting

10.8.1 Resource Management

10.8.2 Halo Vest

10.8.3 Force Vector

10.8.4 Converting to Open Reduction and Internal Fixation

10.9 Conclusion

11 Intubation

11.1 Introduction

11.2 Relevant Anatomy/Physiology

11.3 Indications

11.3.1 Airway

11.3.2 Lung

11.3.3 Tissue

11.4 Contraindications (and Precautions)

11.4.1 General Assessment for Difficult Airway

11.5 Equipment

11.6 Technique

11.6.1 Using Direct Laryngoscope (the Curved Macintosh Blade or the Straight Miller Blade)

11.6.2 Using Video Laryngoscope (Glidescope)—“Down, Up, Down, Up”

11.6.3 Complications/Precautions

11.6.4 Difficult Airway Algorithm

11.6.5 Supraglottic Assist Devices

11.7 Expert Suggestions/Troubleshooting

11.8 Special Circumstances

11.8.1 Intubation of Patients with Maxillofacial Injury

11.8.2 Intubation of Patients with Cervical Spine Trauma

11.8.3 Intubation of Patients with Dislodged Tracheostomy Tube

11.8.4 Intubation of Patients Post Carotid Endarterectomy or Cervical Spine Surgery

11.8.5 Intubation of Patients Post Transphenoidal Surgery

11.8.6 Intubation of Patients with Moya-Moya

11.8.7 Intubation of Morbidly Obese Patients

12 Cricothyrotomy

12.1 Introduction

12.2 Relevant Anatomy and Physiology

12.3 Indications

12.4 Contraindications

12.5 Equipment

12.6 Technique

12.6.1 Preparation

12.6.2 Medications

12.6.3 Positioning/Equipment Set-up

12.6.4 Procedure

12.7 Complications

12.7.1 Acute Complications

12.7.2 Delayed Complications

12.8 Expert Suggestions/Troubleshooting

12.8.1 Controlled Chaos

12.8.2 Time Management

12.8.3 Don’t Lose the Airway

13 Chest Tube Insertion

13.1 Introduction

13.2 Relevant Anatomy/Physiology

13.3 Indications

13.3.1 Emergency Indications

13.3.2 Nonemergent Indications

13.4 Contraindications

13.5 Equipment

13.6 Technique

13.6.1 Preparation

13.6.2 Seldinger Technique

13.6.3 Standard Technique

13.7 Removal

13.7.1 Technique for Removal

13.8 Complications

13.9 Expert Suggestions/Troubleshooting

Index

 

An aparitie	25 Jan. 2021
Autor	Jack I. Jallo, David Slottje
Dimensiuni	20.32 x 12.7 cm
Editura	Thieme
Format	Paperback
ISBN	9781684200177
Limba	Engleza
Nr pag	174