Subarachnoid Hemorrhage And Pregnancy (PART 3)

Other consideration:(4) Fluids and electrolyte changes occur as a result of the increase in interstitial fluid by as much as 6 litres.To maintain this isotonic hyperhydration sodium is retained.  Although total body sodium is increased the serum sodium is 2-3 meq/L below non pregnant level. The infusion of sodium free fluids such as 5% dextrose in water can lead to hyponatremia in mother and neonate (Lind,1983), potassium levels are also somewhat lower in pregnancy. Plasma osmolality is reduced by as much as 10 mosm /kg H20(Hytten 78) within the first few weeks of pregnancy due to the fall in electrolyte and urea. Urea falls in early pregnancy to about a quarter...

Read More

Management of Status Epilepticus (PART 3)

ANESTHETIC CONSIDERATION IN SE:(1) After all standard therapy has failed or has been determined to have unacceptable side effects most neurology textbooks recomend consulting an anesthesiolo gist for administration of general anesthesia to manage SE.Under these situations what anesthetic should be given ? Unfortunately no controlled clinical studies have been conducted to adequately answer this question. Anesthetic drugs that have been used successfully to stop SE include barbitutates,benzodiazepine,propofol,etomidate ketamine,isoflurane,enflurane,and halothane.  If general anesthesia is needed to manage SE a patient outcome is thought to corelate more with the underlying...

Read More

Management of Status Epilepticus (PART 2)

MANAGEMENT OF TONIC- CLONIC  SE:(1,2) Time from initiation of observation and treatment (min)          Procedure =================================================         0                         Assesss cardiorespiratory function                                    as the presence of tonic clonic sta                                    tus is verified.If ensure of diagnosis          ...

Read More