ABSTRACT

Neuroendocrine Increased catecholamines and sympathetic nerve activity Increased cortisol, growth hormone, ACTH, prolactin Increased renin, angiotensin, aldosterone, vasopressin Acute phase reactants-increased coagualability Altered immune response

Pulmonary Decreased pulmonary function Pneumonia ARDS Pneumothorax secondary to barotrauma (yelling, coughing) Increased respiratory rate Acid-base disturbances

Central Nervous System ICP elevation and herniation Spinal cord injury due to struggling against physical restraints and spinal precautions

Cardiovascular SVR increases with tissue hypoperfusion, lactic acidosis and ultimately multi-organ system failure Tachycardia which may complicate assessment of resuscitative measures Ectopy and conduction abnormalities

Gastrointestinal Cushing's ulcers Decreased gut motility

Musculoskeletal Spasm and immobility Rhabdomyolysis from struggling against physical restraints

Genitourologic ATN/renal failure

Table 4.2. Terms and definitions

Analgesia Cerebral resuscitation

Blunting the perception of pain locally or centrally. Management of ICP in head trauma patients via drugs, head elevation, or hyperventilation.