Beyond Indication and Contraindication

Abstract

At the emergency medical center, management of severe brain damage caused by trauma, stroke, brain hypoxia, or cardiac arrest requires an assessment of the condition reversibility in addition to indications for treatment [1,2]. The reversibility of severe brain injury is decided not only by the severity of brain damage, age, time after insult, and original cause of brain damage, but also the level of medical management. For the success of brain hypothermia treatment beyond contraindication, advanced brain hypothermia intensive care unit (ICU) management techniques must be applied early on. Factors that decide the prognosis of severely braininjured patients include the Glasgow Coma Scale (GCS), complicated trauma of major organs, age, sex, start of treatment time, type of original disease, immune activity, and cardiopulmonary function. To introduce the new concept of treatment beyond indication and contraindication, the treatment goal must be determined for each severely brain-injured patient. For instance, injury with a GCS of 3 is very difficult to recover from without neurological deficit or persistent vegetation [1].