Most patients with traumatic brain injury (TBI) suffer secondary brain injury that results in higher mortality rates, additional cognitive and physical impairments, and a longer intensive care unit (ICU) stay. ICU nurses are a critical part of the team in detecting and preventing this injury. Is your care based on the guidelines for managing these patients?

In this issue, McNett and colleagues describe which physiological and situational variables influenced ICU nurse judgments regarding secondary brain injury.

The Brain Trauma Foundation and the American Association of Neurological Surgeons have published guidelines for this care. Nurses should do the following:

  • Consider the “whole picture” when interpreting parameters such as blood pressure (BP), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) in TBI patients.

  • Because BP, ICP, and CPP values are dependent on one another, BP fluctuations can usually be tolerated if ICP remains within normal...

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