Book contents
- Shared Decision Making in Adult Critical Care
- Shared Decision Making in Adult Critical Care
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Chapter 1 When Does Shared Decision-Making Apply in Adult Critical Care?
- Chapter 2 How Much Does the Family Want to Be Involved in Decision-Making?
- Chapter 3 Show Me the Data
- Chapter 4 Communication Skills for Critical Care Family Meetings
- Chapter 5 The Do-Not-Resuscitate Order
- Chapter 6 The Do-Not-Intubate Order
- Chapter 7 Prolonged Ventilator Dependence for the Pulmonary Patient
- Chapter 8 Renal Replacement Therapy
- Chapter 9 Shared Decision-Making during Extracorporeal Membrane Oxygenation
- Chapter 10 Hypoxic–Ischemic Brain Injury after Cardiac Arrest
- Chapter 11 Decompressive Craniectomy for Stroke Patients
- Chapter 12 Decompressive Craniectomy for Traumatic Brain Injury Patients
- Chapter 13 Severe Traumatic Spinal Cord Injury
- Chapter 14 Potentially Inappropriate Treatment and Conscientious Objection
- Chapter 15 Shared Decision-Making in Emergent Situations
- Chapter 16 Advance Directives
- Chapter 17 Care of the Unbefriended Patient
- Chapter 18 The Role of Palliative Care in the Intensive Care Unit
- Chapter 19 Measuring and Evaluating Shared Decision-Making in the Intensive Care Unit
- Chapter 20 Brain Death Discussions
- Index
- References
Chapter 11 - Decompressive Craniectomy for Stroke Patients
Published online by Cambridge University Press: 27 May 2021
- Shared Decision Making in Adult Critical Care
- Shared Decision Making in Adult Critical Care
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Chapter 1 When Does Shared Decision-Making Apply in Adult Critical Care?
- Chapter 2 How Much Does the Family Want to Be Involved in Decision-Making?
- Chapter 3 Show Me the Data
- Chapter 4 Communication Skills for Critical Care Family Meetings
- Chapter 5 The Do-Not-Resuscitate Order
- Chapter 6 The Do-Not-Intubate Order
- Chapter 7 Prolonged Ventilator Dependence for the Pulmonary Patient
- Chapter 8 Renal Replacement Therapy
- Chapter 9 Shared Decision-Making during Extracorporeal Membrane Oxygenation
- Chapter 10 Hypoxic–Ischemic Brain Injury after Cardiac Arrest
- Chapter 11 Decompressive Craniectomy for Stroke Patients
- Chapter 12 Decompressive Craniectomy for Traumatic Brain Injury Patients
- Chapter 13 Severe Traumatic Spinal Cord Injury
- Chapter 14 Potentially Inappropriate Treatment and Conscientious Objection
- Chapter 15 Shared Decision-Making in Emergent Situations
- Chapter 16 Advance Directives
- Chapter 17 Care of the Unbefriended Patient
- Chapter 18 The Role of Palliative Care in the Intensive Care Unit
- Chapter 19 Measuring and Evaluating Shared Decision-Making in the Intensive Care Unit
- Chapter 20 Brain Death Discussions
- Index
- References
Summary
Mr. Johnson is a 62-year-old man with no prior past medical history who is admitted to the intensive care unit (ICU) after suffering a large cryptogenic stroke in the past 24 hours, with the majority of his left middle cerebral artery (MCA) now infarcted on neuroimaging. Despite his being globally aphasic with a right hemiparesis, a gaze deviation to the left, and a right-sided hemianopsia, his eyes initially open to voice easily, he has symmetric pupils, and he is protecting his airway. Several hours later in the ICU, the nurse notes that he still has symmetric pupils, but his eyes now require noxious stimulation to open, and he seems to be snoring. His serum sodium is 145 mEq/L; a repeat computed tomography scan of the head (Figure 11.1) shows that he has developed an interval increase in cerebral edema and now has a few millimeters of left-to-right midline shift. His family “doesn’t want him to die” and is very hopeful that he might improve in the future, saying that he is a very active 62-year-old. You walk into a meeting with the family after ordering mannitol and being told by the nurse that someone on the team had already mentioned the possibility of decompressive craniectomy to them.
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- Shared Decision Making in Adult Critical Care , pp. 93 - 102Publisher: Cambridge University PressPrint publication year: 2021