Traumacast EAST/AAST/AAST-AMC: SCC Review Series - Neurologic Dysfunction I
Aug 15, 2025
Purvi Patel, a trauma and critical care surgeon specializing in brain and spinal injuries, teams up with Caitlyn Braschi, a trauma fellow at LA General USC. Together, they delve into traumatic brain injuries, emphasizing strategies like the Glasgow Coma Scale and the role of beta blockers. The discussion highlights the urgency of addressing cervical spine injuries and their respiratory complications. Patel and Braschi also dissect spinal cord injury classifications and advocate for personalized treatment approaches to improve patient outcomes.
AI Snips
Chapters
Transcript
Episode notes
Early Intubation And Short-Acting Induction
- Intubate trauma patients with GCS ≤8 for airway protection and use short-acting induction agents.
- Use etomidate and succinylcholine to preserve neurologic reassessment within ~10 minutes.
Use TXA Early For Intracranial Bleeds
- Give tranexamic acid within three hours for intracranial bleeding to reduce injury-related death.
- Dose TXA as 1 g bolus then 1 g over eight hours or consider a single 2 g dose per recent practice.
Prevent Secondary Hits And Start Seizure Prophylaxis
- Prevent secondary insults in TBI by avoiding hypoxia and hypotension and start early seizure prophylaxis.
- Use phenytoin for early post-traumatic seizures or levetiracetam (Keppra) pragmatically for fewer adverse effects.