Consult Page 69F altered after a fall, CT brain bleed. Initial Imaging Walking Thoughts ■ What is the current GCS of the patient? Is she able to protect her airway? ■ What is the baseline function of the patient? ■…
Consult Page 77 year old woman with syncope and fall 3 days ago with intracranial bleed on CT Initial Imaging Walking Thoughts ■ What was the etiology of her syncopal event? Why is she presenting 3 days after the fall?…
Consult Page 3 year old girl status post fall with head strike, worsening GCS, CT with large brain bleed Initial Imaging Walking Thoughts ■ What is the patient’s current GCS score and neurological exam? ■ Does the patient have any…
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44.1 Introduction: airliners and operating rooms After the Institute of Medicine reported up to 98,000 annual deaths in the United States from medical errors, a new focus on error causation and its possible amelioration began . As many as two-thirds…
43.1 Introduction Evidence-based medicine (EBM) has been described as a search for a science of clinical care . Many of its core concepts and methods in use today can be traced to the field of epidemiology and the pioneering efforts…
42.1 Introduction Intraoperative neurophysiology (ION) evolved from existing technologies in evoked potentials, electromyography (EMG), and nerve-conduction studies to give real-time information for surgeons performing procedures that may imperil nervous system structures. The usage of ION has spread over time from…
41.1 Introduction Intraoperative neurophysiology normally improves patient safety, but like any medical procedure it can cause inadvertent harm. This chapter reviews electrical and procedure-specific safety, infection control, and essential performance in terms of potential hazards and their means of protection.…
40.1 Anesthesia: safety, comfort, and facilitation of the procedure The anesthesiologist is a key member of the team conducting the intraoperative neurophysiology (ION), whether the monitoring is surgical in the operating room, or procedures such as neurovascular embolization, in the…
39.1 History Despite clear advantages over complex repair-strategies of irreversible structural changes, selective dorsal rhizotomy (SDR) is still not recognized as an early prophylactic surgical option in most current guidelines. This striking reluctance can be understood by examining the fraught…