The Brainstem Rules of Four
'The Brainstem Rules of Four' is an approach to the anatomic localization of brainstem lesions developed by Dr Peter Gates
Category CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Bulbar Dysfunction in ICU
Bulbar Dysfunction in ICU
Cerebral oedema
TYPES Cytotoxic edema Vasogenic edema CT FEATURES OF RAISED ICP References and Links
Examination of the unconscious patient
Coma is a state of unconsciousness caused by temporary or permanent impairment of the ascending reticular system in the brainstem, or both cerebral hemispheres.
Delayed Awakening in ICU
Delayed Awakening in ICU
Eye Movements in Coma
A simplified approach to spontaneous eye movements in coma
GBS vs CIP
OVERVIEW References and Links
Ranitidine
Ranitidine: H2 receptor antagonist; competitive blockade of H2 receptors -> decrease in secretion; also decreases action of gastrin and acetylcholine
Magnesium
Magnesium: electrolyte (second most abundant cation in intracellular fluid, after potassium); depresses neuronal activation; essential cofactor in >300 enzyme systems
Alkali Therapies
Alkali Therapies: sodium bicarbonate; THAM; Carbicarb; Dichloroacetate; Dialysis / hemofiltration
Alfentanil
Alfentanil: synthetic mu-opioid receptor agonist analgesic drug. Analogue of the synthetic opioid fentanyl that is only 10% as potent (on a weight-to-weight basis), but has quicker onset, quicker time to maximal effect, shorter duration of action (10 minutes), is more cardiovascularly stable and has more respiratory depression
Alteplase (rtPA)
Alteplase is a tissue plasminogen activator used as a thrombolytic medication in: Acute Ischaemic Strokes, Acute Myocardial Infarction and PE