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Chapter 76 - Head Trauma

from Section 9 - Trauma Anesthesia

Published online by Cambridge University Press:  03 August 2023

By
Jeffrey Neurock  and
Jessica A. Lovich-Sapola
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 40-year-old man presents to the trauma bay after a prolonged extrication, following an ATV accident. He is intoxicated, incoherent, and combative. The trauma team would like to sedate the patient for a CT scan to evaluate his head, abdomen, and pelvis. The patient’s blood pressure is 170/90 mm Hg, heart rate is 48 beats/min, and temperature is 35.5 °C. What are your concerns in a traumatic brain injury (TBI) patient? How will you evaluate the patient? How will you induce and maintain general anesthesia in this patient?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 316 - 319
Publisher: Cambridge University Press
Print publication year: 2023

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References

Barash, PG, Cullen, BF, Stoelting, RK, et al. Clinical Anesthesia, 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, pp. 1499–502.Google Scholar
Brain Trauma Foundation. Guidelines for the management of severe traumatic brain injury, 3rd ed. J Neurotrauma 2007;24S:1–95.Google Scholar
Gropper, MA. Miller’s Anesthesia, 9th ed. Philadelphia: Elsevier, 2020, pp. 1868–910, 2115–42, 2680–2.Google Scholar
Han, C, Yang, F, Guo, S, et. al. Hypertonic saline compared to mannitol for the management of elevated intracranial pressure in traumatic brain injury: a meta-analysis. Front Surg 2022;8:765784CrossRefGoogle ScholarPubMed
Lim, HB, Smith, M. Systemic complications after head injury: a clinical review. Anaesthesia 2007;62:474–82.CrossRefGoogle ScholarPubMed
Moppett, IK. Traumatic brain injury: assessment, resuscitation and early management. Br J Anaesth 2007;99(1):18–31.CrossRefGoogle ScholarPubMed

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