What is your cocktail for post TBI / concussions patients?

[DendriticCell]

To those had experience working with trauma patients (especially weaning them off from vent),

What are your regimen of meds / or sedation gtt to treat pt with post TBI/concussions to prevent them going into this delirium or psychosis stage, especially when we are doing weaning and turning off sedation? We have been using either haldol and precedex, but they had not shown promising results. thanks

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[jdh71]

Sometimes, especially in someone with brain trouble, you don't get them to settle down, you have to nut up, pull the tube, and see how they do if it looks like they otherwise can breathe on their own.

 

[iridesingltrack]

Sometimes, especially in someone with brain trouble, you don't get them to settle down, you have to nut up, pull the tube, and see how they do if it looks like they otherwise can breathe on their own.

This.

But, to be more specific I use a lot of seroquel, propranolol, trazodone, haldol and often even a stimulant like provigil, amantidine, bromocriptine, or Ritalin. Not all together of course it really depends on what you are seeing: is the patient delirious, in pain, surging etc.? For extubation, I often begin these meds as I am coming off sedation and use precedex as well. Unfortunately, as above sometimes you just got to pull and pray.

Iride