Raised intercranial pressure (ICP)

[bekib86]

Does raised ICP indicate a possible decrease in consciousness? ie can it lead to a coma? or is a sign before someone goes into a coma?
Thanks
Beki

[ianhutch]

Raised ICP is extremely likely to decrease consciousness & even kill. It depends on the cause. Trauma may cause bleeding inside the skull or pressure from a fractured skull. These are dire emergencies & would often involve helicopter transfer to hospital. A spontaneous bleed, sometimes called a CVA or stroke would also produce the same result. This can happen at any age due to a number of causes such as weak blood vessels, high blood pressure etc. The other type of stroke (a blockage) is often less serious & is usually an older patient. There are other, long-term causes but the above are potential killers. The Stroke Association has some good info including their FAST campaign.

[bekib86]

Thanks for this, i am doing an essay on CVA at the moment and you seem to know quite a bit. I have just posted again asking why does BP raise after a stroke? what happens in the body to make BP rise?
Thanks

[ianhutch]

I run a first aid training company & my knowledge is on the acute side of medicine rather than the physiology. A stroke, as you obviously know, affects the brain circulation with either a bleed or blockage. The blood pressure is controlled by many factors in the body and some areas of the brain will affect it, but for exactly which areas etc you would need to consult a physiology source. Sounds like an interesting essay!

[bekib86]

Ok thanks for your help. I may be able to miss that bit out as its more about nursing interventions than anything. Thanks again
x

[ianhutch]

The most important intervention in the field is 100% oxygen & elevation of the head in a conscious patient. Other IV stuff is the paramedic's job, but many patients would have far less damage if they were sat up rather than laid down in the 'Recovery position' as often happens. I believe this is a dangerous name as trainees lock into it & put everyone in it. It is positively damaging for a haemorrhagic stroke as it pushes the blood straight to the bleed! If they can maintain their own airway, sit them up. The old saying is "face pale, raise tail; face red, raise head" obviously allowing for natural colour! Raised ICP pushes the blood to the skin & hence it's a fairly good rule-of-thumb.

[bekib86]

Thanks for all your help!!