ICH with intraventricular bleeding and midline shift
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General Critical Care
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The hospital manager called me inquiring about the availability of a vacant bed in ICU to accept a patient from another hospital.
I told him that at that moment no vavcancy but I expected a bed to be vacant in few hours time as there was a terminal patient guessed to pass away shortly.
The story of that terminal patient was :
60 years old, end stage renal disease on regular dialysis for years, prostate cancer with metastasis everywhere, paraneoplastic syndrome.
He was admitted in the ward due to hemodynamic instability and progressive dyspnea ; managed palliatively.
Fully conscious.
Noor Ali Shah
Sep 01
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I do agree with Dr. Mazen opinion. Such terminal patient should not be admitted and intubated. We are not the one who give timeline of death. Reference to Quran surah al Luqman-34 verse
إِنَّ ٱللَّهَ عِندَهُۥ عِلْمُ ٱلسَّاعَةِ وَيُنَزِّلُ ٱلْغَيْثَ وَيَعْلَمُ مَا فِى ٱلْأَرْحَامِ ۖ وَمَا تَدْرِى نَفْسٌۭ مَّاذَا تَكْسِبُ غَدًۭا ۖ وَمَا تَدْرِى نَفْسٌۢ بِأَىِّ أَرْضٍۢ تَمُوتُ ۚ إِنَّ ٱللَّهَ عَلِيمٌ خَبِيرٌۢ ٣٤
Indeed, Allah ˹alone˺ has the knowledge of the Hour. He sends down the rain,and knows what is in the wombs. No soul knows what it will earn for tomorrow, and no soul knows in what land it will die. Surely Allah is All-Knowing, All-Aware.
Hopefully you got the answer.
In addition for critical care admission, always follow the principles of ethics. One culomn of ethics is distributive justice. Do justice always irrespective of who is calling.
If you read the criteria of admission in critical care unit on priority basis, you can decline admission to critical care unit on following basis.
“1. The patient who are too well, should not be admitted to critical care unit as they can be easily managed in general ward.”
“2.The patient who are too sick and terminally ill, can not be benefited in admission to critical care unit. “
Jazak Allah khair.
Edited
Normal Hepatopetal flow of the portal vein without fluctuation or retrograde flow (i.e blood flow towards the liver. from the portal hepatis to the liver periphery).
I finished Pain, Agitation, Delirium, Immobility and Sleep Disruption in the ICU (PADIS Guidelines)! 🚀
I thank Dr. Mazen for this very important course, for its smoothness, ease and diversity, and I thank Dr. Noor for spreading the spirit of hope and activity.
May Allah reward you
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- Hussain Al-shabib
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Findings:
Intracerebral Hemorrhage (ICH) with extension to the lateral ventricules: The hyperdense area is indicative of acute blood, and the size suggests a significant hemorrhage
2. Surrounding Edema: There appears to be hypodense areas around the hemorrhage, indicating cerebral edema.
3. Possible Midline Shift: There may be some degree of midline shift, suggesting raised intracranial pressure.