Closed Head Injuries

Closed Head Injuries is a topic covered in the Pocket ICU Management.

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Anesthesia Central

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First Things First (assess & treat for the following):

  • Ensure airway and breath sounds.
  • Ensure IV access and perfusion.
  • What is the current neuro status?
    • Determine Glasgow Coma Score (GCS); see “History and Physical” section
    • Serial neuro exams
    • Action for deteriorating exam
    • Lateralizing findings (ie, hemiparesis; suggest surgical lesion)
  • Hypoxic or hypotensive?
    • Correct ASAP to prevent further ischemia.
    • Intubation if GCS 8 or less
    • Maintain O2 sat >90%.
    • Maintain SBP >90 mmHg (increased mortality for each hypotensive or hypoxic episode).
  • C-spine protected?
    • Frequent co-injury w/ traumatic brain injury (TBI)
    • Other injuries are difficult to identify & treat in TBI pts.

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Last updated: April 14, 2010