Casualties with moderate/severe TBI should be monitored for:
Decreases in level of consciousness
Pupillary dilation
SBP should be >90 mmHg
O2 sat > 90
Hypothermia
PCO2 (If capnography is available, maintain between 35-40 mmHg)
Penetrating head trauma (if present, administer antibiotics)
Assume a spinal (neck) injury until cleared.
Unilateral pupillary dilation accompanied by a decreased level of consciousness may signify impending cerebral herniation; if these signs occur, take the following actions to decrease intracranial pressure:
Administer 250 cc of 3 or 5% hypertonic saline bolus.
Elevate the casualty’s head 30 degrees.
Hyperventilate the casualty.
Respiratory rate 20
Capnography should be used to maintain the end-tidal CO2 between 30-35
The highest oxygen concentration (FIO2) possible should be used for hyperventilation.
Decreases in level of consciousness
Pupillary dilation
SBP should be >90 mmHg
O2 sat > 90
Hypothermia
PCO2 (If capnography is available, maintain between 35-40 mmHg)
Penetrating head trauma (if present, administer antibiotics)
Assume a spinal (neck) injury until cleared.
Administer 250 cc of 3 or 5% hypertonic saline bolus.
Elevate the casualty’s head 30 degrees.
Hyperventilate the casualty.
Respiratory rate 20
Capnography should be used to maintain the end-tidal CO2 between 30-35
The highest oxygen concentration (FIO2) possible should be used for hyperventilation.
Respiratory rate 20
Capnography should be used to maintain the end-tidal CO2 between 30-35
The highest oxygen concentration (FIO2) possible should be used for hyperventilation.
Notes:
Do not hyperventilate unless signs of impending herniation are present.
Casualties may be hyperventilated with oxygen using the bag-valve-mask technique.
Tactical evacuation care
Emergency Medical Treatment and Active Labor Act
CT brain interpretation
Prehospital protocol pediatric airway management
Tactical field care
Ventriculoperitoneal shunt drainage
Neuro antibiotics
Newborn resuscitation