1.Environment When the patient is admitted to ICU room, the indoor temperature is controlled at 18℃~21℃, humidity 50% to 70%, indoor air is ventilated at regular intervals, and ultraviolet ray is sterilized. Prepare artificial respiration balloon, suction device, stethoscope, ice bag or ice lolly, first aid medicines and instruments, specialized nursing record sheet, and so on. 2.Temperature Check the patients once every 30 minutes, check the running temperature of the cooling blanket, avoid the temperature of the cooling blanket is too high or too low. Body temperature is mainly measured by anal temperature, with 33℃~35℃ as the target temperature, and skin ice packs are added to assist cooling when necessary. During subcooling treatment, continuous dynamic monitoring of the patient’s anal temperature is important. A small number of patients with anal temperature below 34 ℃ will cause reflex coronary artery contraction and lead to atrioventricular block, at this time, cardiac monitoring will find arrhythmia, to immediately notify the doctor to deal with. 3, consciousness, craniocerebral injury patient’s condition change process is roughly clinical symptoms – degree of consciousness – pupil changes, consciousness is an important indicator to reflect the severity of brain injury. When the patient’s consciousness changes from awake – drowsiness – irritability – coma, it is a direct reflection of the progressive aggravation of brain injury. When double upper limb flexion or limb ankylosis occurs, it suggests that there is brain stem injury. When the patient is found to have changes in consciousness, notify the doctor for treatment. 4.Intracranial pressure Use intracranial pressure monitor of ventricular catheter method to monitor intracranial pressure, evaluate the change of intracranial pressure according to the displayed data, and guide the treatment measures such as cooling and dehydration. When ICP>2.7kpa, it is necessary to take measures to reduce cranial pressure such as release of cerebrospinal fluid and intravenous mannitol. When the treatment is ineffective, review the cranial CT. 5. Pupil Observe the pupil every 30min, pay attention to the shape and size of the pupil, the reaction to light and whether the eyeball is fixed or not, and record in detail. Bilateral pupil pinpoint size, suggesting brain stem injury or ventricular hemorrhage; found that one or both sides of the pupil dilation, reaction to light disappears, suggesting the formation of brain hernia; immediately notify the doctor. When observing the pupil, it is necessary to distinguish it from the pupil dilation caused by primary motor nerve injury, and it should also be noted that individual patients in the early stage of brain herniation will appear “anti-sign”, that is, the pupil of the opposite side of the hematoma is dilated. 6.Vital signs Monitor with multi-parameter monitor, and measure blood pressure once every 30 minutes. When the intracranial pressure increases, the vital signs may show “two slow and one high”, i.e. slow pulse, slow respiration and high blood pressure. However, this is not typical and the most common condition is an increase in blood pressure. The most common situation is increased blood pressure. Increased heart rate is fast to pay attention to whether the blood volume is insufficient, shallow and slow respiration is related to pethidine, in short, the vital signs of disorders should be reported to the doctor in time to deal with timely. 7.Respiratory tract Tracheotomy is often needed in the subcritical treatment of patients with severe craniocerebral injury, and sputum should be sucked out in time to ensure that the respiratory tract is smooth. Therefore, the aseptic care of trachea should be strictly done. Boil the inner tube of tracheal cannula once a day for 30 minutes, drop gentamicin solution (0.9% sodium chloride injection 100ml + gentamicin 80,000u + dexamethasone 5mg + chymotrypsin 4,000U) into the trachea every 2 hours for 5-8 drops, and nebulized inhalation 3 times a day. When there is sputum timely suction, sputum suction tube held in the right hand into the trachea to a certain depth (20cm) and then open the negative pressure, left and right rotating attraction slowly outward, the requirements of the action is gentle, do not cause violent coughing, not allowed to be back and forth insertion, so as to avoid damage to the mucous membrane of the trachea. The suction tube should be 14 to 16, and the oral and tracheal suction tubes should be placed in different disinfectant bottles. Strictly aseptic operation to prevent cross-infection. 8.Emphasize basic nursing care to prevent various complications (1) Oral care: clean the mouth with oral care solution 2-3 times a day. Suck out the secretion in time, take out the denture, reduce the misuse of suction. Elevate the head of the bed by 20 degrees and fix the gastric tube. (2) Skin care: the bed sheet is smooth without folds, remove all the patient’s clothes, turn over once every 2h, knock the bilateral back with the palm for 10 minutes, gently massage the pressurized skin, take a bath with lukewarm water, promote the blood circulation of the skin, keep the skin clean and dry, and trim the fingernails (toes) in a timely manner. Prevent bedsores. (3) Perineal care: disinfect the urethral opening with 0.5% povidone-iodine solution 2 times/d, bladder irrigation (NS250ml+gentamicin 80,000u) 2 times/d. Keep the catheter clear. The urine bag was placed under the bed to prevent urine backflow, and the catheter was changed once every two weeks to train the bladder function as early as possible. After the bowel movement, wash with warm water in time, apply talcum powder, and keep the perineum dry and clean. (4) Upper gastrointestinal bleeding care: heavy craniocerebral injury is often accompanied by stress gastrointestinal ulcer bleeding, hemorrhage can lead to shock or even death. Therefore, it is important to put in gastric tube to find bleeding at early stage. All patients in this group were put under gastric tube after admission to the hospital with external negative pressure device and observed for 24 hours. When coffee-colored fluid or positive occult blood appeared, fasting was done immediately, in addition to the intravenous application of acid-producing drugs, Yunnan Baiyao could be injected into the gastric tube 3 times/d. If the bleeding was large, 50ml of saline + thrombin 2000U or 50ml of ice saline + norepinephrine 2mg was injected into it from the gastric tube.