Inpatient Consultants: Building a PM&R Inpatient Consult Service: How to Develop Practice Guidelines for Acute SCI and BI Management-Inpatient Consultants: Building a PM&R Inpatient Consult Service: How to Develop Practice Guidelines for Acute SCI and BI Management

Inpatient Consultants: Building a PM&R Inpatient Consult Service: How to Develop Practice Guidelines for Acute SCI and BI Management

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Video Transcription

Video Summary

In this video summary, a panel discusses inpatient consultation for brain and spinal cord injuries. They stress the importance of providing valuable information and medical recommendations tailored to each patient's needs. Bladder and bowel management for spinal cord injury patients is also discussed, with recommendations including leaving Foley catheters in until urine output stabilizes and using intermittent catheterization. For bowel management, they suggest bulking agents, manual disinfection, and mini enemas for mechanical flushing of stool. Lidocaine jelly is mentioned for minimizing autonomic dysreflexia in complete spinal cord injury patients, and transanal irrigation is considered for those with difficulty in regular bowel programs. The panel emphasizes individualized care and considering patient-specific needs.<br /><br />Two brain injury cases are discussed, with recommendations for each. In the first case, the patient had persistent fever, tachycardia, restlessness, and irritability. The panel recommends bromocriptine for paroxysmal sympathetic hyperactivity, along with propranolol for tachycardia and hypertension. Pain management, hydration, nutrition, and regular repositioning are also highlighted. In the second case, the patient was in a minimal conscious state. The panel suggests a trial with amantadine, known for its effectiveness in waking patients from disorders of consciousness. Reviewing medications for sedating effects and optimizing sleep patterns are also advised, along with considering other factors like seizures or hydrocephalus. Coma recovery scales and possibly ambien are mentioned as monitoring tools. The panel underscores the importance of a multimodal approach and individualized management.<br /><br />No specific credits are mentioned in the summary.

Keywords

inpatient consultation

spinal cord injury

bladder management

bowel management

Foley catheters

lidocaine jelly

transanal irrigation

paroxysmal sympathetic hyperactivity

minimal conscious state

amantadine

multimodal approach