A 45-year-old male patient present to the emergency department with a severe head injury following a car accident. His Glasgow Coma Scale (GCS) score is 8, and he shows signs of increased intracranial pressure (ICP). Which of the following interventions should be prioritized to manage his ICP?
Administering mannitol intravenously
Encouraging the patient to hyperventilate
Administering a high-dose corticosteroid
Performing a lumbar puncture immediately
The Correct Answer is A
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.
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