"ATV Accident"

ID Statement:
14yo F presenting as Level 1 trauma 2/2 to ATV accident

Pre-Hospital Course:
* un-helmeted
* found unresponsive and seizing
* intubated by EMS

ED evaluation:
* presenting GCS 3T
* pupils non-reactive
* given hyperOSM therapy
* trauma labs and imaging obtained

OR intervention: epidural hematoma evacuation

PICU Course:
* RESP: MV titration to achieve goal PaCO2 and PaO2
* CV: CPP goal > 60
* FEN/GI: NPO with IVF. 3% HTS infusion (goal Na > 145)
* NEURO: sedated and paralyzed, cEEG with scheduled Keppra prophylaxis, C-collar, ICP monitor (EVD + Codman). Intracranial HTN (ICP > 20 mmHg) treated with sedation and hyperOSM therapies
* ID: Artic Sun applied to keep patient normothermic. Unasyn for aspiration

Hospital Course: transferred to floor on day 14 and ultimately discharged to inpatient rehab

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