Challenges in the nursing care of intracranial carbapenem-resistant Escherichia coli infection after severe traumatic brain injury: a case report.

This article described a case of intracranial carbapenem-resistant Escherichia coli (CRE) infection after severe traumatic brain injury (TBI) and summarized the nursing experience. Since the intracranial infection was confirmed in the early stage and added secondary intracranial hypertension will directly affect the prognosis, the responsible nurse is required to increase the frequency of ward patrol, carefully observe the patient's consciousness and pupil changes, monitor vital signs and improve relevant records, communicate with the competent doctor in time, use drugs, or physical cooling to control high fever as soon as possible. Intensive observation and nursing care included: (I) position management; (II) observation on the state of illness during injection; (III) observation on the state of illness during tube clamping period; (IV) nursing after recovery of drainage; and (V) drug treatment after removing the drainage tube of the lumbar cistern. Artificial airway management included (I) position management, (II) periodically evaluate the artificial airway, (III) airway humidification and warming, (IV) management over airbags, (V) aspirate sputum as needed and (VI) oral care. With appropriate antibiotic drugs, reasonable arrangements to observe the curative effect, and cooperation with doctors, targeted artificial airway management to reduce the risk of airway infections, we treated this patient effectively and successfully. The intracranial infection was effectively controlled after 15-day treatment and nursing in our department, and the patient received an excellent prognosis finally.