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Traumatic Brain Injury Case Study

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Head injuries are among the most common types of trauma encountered in emergency department (EDs). Many patients with severe brain injuries die before reaching a hospital, with almost 90% of prehospital trauma-related deaths involving brain injury. The prime goal of treatment for patients with suspected traumatic brain injuries (TBI) is to prevent secondary brain injury. Providing adequate oxygenation and maintaining blood pressure at a level that is sufficient to perfuse the brain are the most important ways to limit secondary brain damage and thereby improve the patient’s outcome. Subsequent to managing the ABCDEs, identification of a mass lesion that requires surgical evacuation is critical, and this is the best achieved by immediately obtaining a computed tomographic (CT) scan of the head. Obtaining CT scan should not delay transfer process to a trauma centre that is adept of immediate and definitive neurosurgical management. …show more content…
For facilities without neurosurgical coverage, prearranged transfer agreements with higher-level facilities should be in place. Consultation with a neurosurgeon early on the course of treatment is strongly recommended.
The GCS score is used as an objective clinical measure of the severity of brain injury. A GCS score of 8 or less has become the generally accepted definition of coma or severe brain injury. Patients with a brain injury who have a GCS score of 9 to 12 are categorized as moderate, whereas individuals with a GCS score of 13 to 15 are designated as minor. In assessing the GCS score, when there is right/left or upper/lower asymmetry, it is important to use the best motor responses predictor of outcome. However, recording the actual response on both sides of the body, face, arm and

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