Maryland CC Project Stein – Contemporary Management of the Patient with Severe Traumatic Brain Injury
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Mar 11, 2021 
Dr. Deborah Stein, MD, MPH, FACS, FCCM, a leading expert in trauma and severe traumatic brain injury, discusses critical strategies in managing TBI. She highlights the decline in TBI mortality rates linked to safety measures like seatbelts. Stein emphasizes the importance of preventing secondary brain injuries and managing intracranial pressure effectively. She also covers essential treatment approaches, including guidelines for neurosurgical intervention and innovative therapies like plasma for TBI. Throughout, she stresses the need for a balanced, multimodal approach to critical care.
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TBI Is A Major Public-Health Burden
- Traumatic brain injury (TBI) is the leading cause of death after injury and causes huge societal costs.
- Survivors face long-term risks like depression, substance abuse, repeat injury, and criminality.
Safety Measures Lower TBI Mortality
- Mortality from TBI has decreased while incidence recognition has increased.
- Seatbelts and vehicle safety innovations drove sharp reductions in crash deaths.
Prioritize Oxygenation And Blood Pressure
- Prevent hypoxia and prevent hypotension — these are the two most important interventions in acute TBI care.
- Focus initial resuscitation on maintaining oxygenation and adequate blood pressure to reduce secondary injury.