Head Trauma

Abstract

Initial assessment and management of the head trauma victim involve securing the patient’s airway, breathing, and circulation. Moderate to severe traumatic brain injury (TBI) is associated with ~5 % incidence of concomitant cervical spine injuries, and maintenance of spinal immobilization is necessary, particularly in the obtunded patient. Nasogastric intubation in patients with severe craniofacial trauma or evidence of skull base fractures risks intracranial misplacement of the tube. One should promptly correct hypoxia (SpO₂ < 90 %), hypoventilation, and hypotension (SBP <90 mmHg) that occur at any point during the initial resuscitation to minimize risk of secondary brain injury. A focused medical history (including usage of anticoagulant/antiplatelet medicines) and a thorough understanding of the mechanism of injury and the energy involved in the accident are essential.