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Fentanyl and the Neurologically Injured Patient
- Emergency providers routinely care for neurologically injured patients, such as those with a SAH or TBI.
- Many of these patients will require airway management. In these patients, it is important to minimize any increase in ICP, as this can adversely effect cerebral perfusion pressure.
- When intubating the neurocritical care patient, consider a dose of fentanyl (2 to 5 mcg/kg) prior to intubation. This has been shown to decrease the sympathomimetic response to laryngoscopy.
References
Bucher J, Koyfman A. Intubation of the neurologically injured patient. J Emerg Med 2016; 49:920-7.