Traumatic Head Injury: A Case Study

620 Words3 Pages
PRE-HOSPITALMANAGEMENT OF TRAUMATIC BRAIN INJURY Pre-hospital management of patients with a traumatic head injury is determined by a number of factors, including mechanism and severity of injury, accurate and timely GCS and rapid transport (Davis, 2005). A primary survey should be addressed first, which consists of dangers, response, airway (including cervical spine injury assessment), breathing, circulation and haemorrhage. Once dangers are cleared and a pulse is obtained, the airway and breathing should be assessed and 100% oxygen administered, as head injury falls within the critical illness category of the Victorian Clinical Practice Guidelines (CPGs) (Ambulance Victoria, 2014). Even though the patient has an SpO2 of 95%, oxygen therapy is essential to prevent the SpO2 dropping below 90%, which would be a significant determinant of mortality. Simultaneous protection of the cervical spine by immobilisation with a cervical collar is also fundamental due to the mechanism of…show more content…
Criteria for endotracheal intubation is a GCS < 10 when it is a result of a neurological injury (Ambulance Victoria, 2014). Avoiding airway adjuncts such as oropharyngeal or nasopharyngeal airways prevents a gag reflex or potential direct pressure to the brain on which would be detrimental to CPP. Endotracheal intubation enables adequate oxygenation, a patent airway and monitoring of end-tidal carbon dioxide (EtCO2), which is a key indicator for helping to prevent the potential secondary brain injury effects of hypo or hypercapnia. To prevent this occurring, EtCO2 should be maintained at 30-35mmHg (Winchell, 1997). If endotracheal intubation is not available and tidal volume is adequate, ventilation with a bag valve mask alone should take place (Ambulance Victoria,

More about Traumatic Head Injury: A Case Study

Open Document