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Traumatic brain injuries (TBI)


Traumatic brain injuries (TBI)
Traumatic brain injuries (TBI)
Traumatic brain injuries (TBI)
Traumatic brain injuries (TBI)

It is any episode of trauma to the head (brain). Mortality is high.

Signs and Symptoms

Diagnostic Criteria

• Head injury may be associated with ophthalmic, ENT and dental injuries which are discussed separately.
• It is classified into two:

o Involving scalp only
o Traumatic brain injury

Refers to Picture 1: Illustration of Traumatic Brain Injuries



Community/Dispensary level Interventions

• Clean and dress any wound
• If unconscious, ensure airway is patent
• Keep patient warm
• Put in coma position
• Prevent spinal injury by stabilizing the neck with neck collar
• Refer to the centres/health facilities where there is expertise

Health Centre Interventions

• Take full history from patient, relatives or whoever has brought patient where indicated, follow the ABCDE trauma protocol
• Ensure adequate oxygenation by mask or ETT
• Surgical debridement and suture wound as appropriate
• Record and monitor vital signs including pupil size and symmetry
• Give IV line Normal saline or Ringer’s lactate (do not give dextrose infusion!)
• Catheterize
• Refer if moderate or severe TBI, seizure or pupil asymmetry.

Hospital Level Interventions

• History as above, follow the ABCDE trauma protocol
• Examine patient thoroughly, note the level of consciousness, pupils’ asymmetry and any lateralizing signs
• Treat seizures by:

o Diazepam inj. 10mg 8 hourly
o Phenobarbitone inj. 100mg 8 hourly
o Phenytoin inj 100mg 8 hourly

• Brain CT scan if GCS score is 9 or below (absolute indication), GCS 10–14 relative indication for CT scan Admit to ICU if GCS score is 8 and below, or refer if required
• Craniotomy is indicated for specialist cases e.g. intracranial hematomas, depressed skull fractures based on pupil asymmetry, lateralizing signs and brain CT scan
• Refer orConsult the specialist if indicated especially moderate and severe traumatic brain injury, pupil asymmetry is noted or evidence in brain CT scan

  • Pharmacological

  • Non-pharmacological


Updated on,

26 Novemba 2020 12:20:40


    1. STG
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