CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E225 – Head Trauma
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May 3, 2021 Dive into the complexities of traumatic brain injury, distinguishing between mild, moderate, and severe cases. Explore the critical implications of cerebral autoregulation and how it affects treatment. Uncover the differences between primary and secondary brain injuries, and learn about various brain herniation types. Get insights on managing head trauma, including imaging protocols and decision rules for mild TBI. Find out how to support safe recovery for athletes post-concussion with a graduated return-to-play protocol.
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TBI Classification by GCS
- Use Glasgow Coma Scale (GCS) scores to categorize traumatic brain injury severity: 13-15 mild, 9-12 moderate, 3-8 severe.
- Remember that mild TBI patients with stable or improving GCS rarely need CT interventions.
Cerebral Autoregulation and CPP
- Cerebral perfusion pressure (CPP) equals mean arterial pressure (MAP) minus intracranial pressure (ICP).
- Increasing MAP can constrict cerebral vessels and reduce ICP if autoregulation is intact.
Prevent Secondary Brain Injury
- Prevent secondary brain injury by avoiding hypotension, hypoxia, anemia, hyperpyrexia, and abnormal PaCO2.
- Treating these factors early can significantly reduce mortality and worsen outcomes.