Protocol for intravenous barbiturate therapy in increased intracranial pressure in a community hospital

A barbiturate protocol for control of raised intracranial pressure is presented in detail. Since the nursing staff may be responsible for maintaining cerebral perfusion and normal ICP with barbiturates, mannitol, fluids, and pressor agents, it was thought that a detailed description such as presented might be useful. We have shown that complex management protocols can easily be managed, even in smaller, non-university community hospitals. The present state of brain injury management by barbiturates, guided by ICP monitoring, even at this early stage of development, seems to show promise as the latest adjunct in the care of this difficult problem.