Pilot Implementation of Quantitative Pupillometry for ICH Patients in the ICU
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Intracranial Hemorrhages (ICH) are catastrophic neurological events that are associated with high mortality rates within the first few months following the initial insult, high rates of disability, and poor quality of life for many years in those who do survive. Close monitoring is required in an intensive care unit after ICH, which typically includes traditional subjective means of assessing pupillary light reflex through a penlight and pupil size gauge. Recent literature supports the implementation of standardized, regular, quantitative pupillometry assessments to garner objective, continuous data that enables more rapid identification of early neurologic change and deterioration using a pupillometer. While this method is supported by the literature, this device is not yet in use in the intensive care units at a regional Pacific Northwest hospital. This paper will discuss the importance of non-subjective pupillometry readings in ICH patients, supported by a review of the literature, and include the pilot program guideline for the initial implementation of standardized quantitative pupillometry at this hospital.
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