MedBugs: SAQ #304

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Case: Ventriculoperitoneal shunt failure

A 21-year-old woman with a VP shunt presents with worsening headache, nausea, lethargy and reduced GCS. Obs on arrival : T 37.9

HR 80
BP 130/70
RR 16
Sats 98%RA
GCS E3V4M5 = 12 (baseline 15)

1. What is your main concern? 1 mark

2. List and justify three specific investigations you would organise. 6 marks

On return from radiology the nurse rushes up to inform you that the patient’s GCS has dropped to 9 and she is becoming more bradycardic and hypertensive.

3. State five strategies for managing this patient’s raised intracranial pressure. 5 marks

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Case: Ventriculoperitoneal shunt failure

1. What is your main concern? 1 mark

2. List and justify three specific investigations you would organise. 6 marks

3. State five strategies for managing this patient’s raised intracranial pressure. 5 marks

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