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Equipment/Software
 
Aliases:
Cranial fixation pins
mayfield pins
mayfield head pins

Topic aliases are alternate phrasings for a particular topic.


If CPR is required in a small child whilst in pins, one option is to leave the child's head in pins and have the neurosurgeon place hands posteriorly and anteriorly on the chest and compress.

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If CPR is required in an adult whilst in pins, detach the pin contraption at the table (stilll attached to patient's head) and have the neurosurgeon hold it whilst somebody else performs the chest compressions.

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Maintain anaethesia until the patient is out of the pins to minimise the risk of movement and secondary trauma.

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When using remifentanyl for induction prior to craniotomy commence at 0.3mcg/kg/min, decreasing to 0.2mcg/kg/min post intubation. No extra bolus is required for pin placement as long as you are sure it has made it into to the patient.

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Ensure adequate analgesia is on board at the time of their placement to blunt the sympathetic hypertensive response.

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