TBI Acute Care & Emergency Management Flashcards

What is the primary goal of acute TBI management in the emergency setting?

Answer: Prevent secondary brain injury

The primary goal is to prevent secondary brain injury by maintaining adequate oxygenation, perfusion, and controlling intracranial pressure.

A Glasgow Coma Scale (GCS) score at or below which value indicates severe traumatic brain injury?

Answer: 8

A GCS score of 8 or below indicates severe TBI, requiring aggressive management including airway protection and ICP monitoring.

According to Brain Trauma Foundation guidelines, what is the target intracranial pressure (ICP) in acute severe TBI management?

Answer: Less than 20-22 mmHg

Current Brain Trauma Foundation guidelines recommend maintaining ICP below 20-22 mmHg to prevent herniation and secondary brain injury.

Which intervention is considered a simple first-line measure for reducing elevated ICP in acute TBI?

Answer: Head-of-bed elevation to 30 degrees

Elevating the head of the bed to 30 degrees promotes cerebral venous drainage and reduces ICP without significantly compromising CPP.

According to Brain Trauma Foundation guidelines, what is the recommended cerebral perfusion pressure (CPP) target in adult severe TBI?

Answer: 60-70 mmHg

The Brain Trauma Foundation recommends a CPP target of 60-70 mmHg to ensure adequate cerebral perfusion without causing excessive cerebral blood flow.

What is the primary mechanism by which brief hyperventilation temporarily reduces ICP in acute TBI?

Answer: Causes cerebral vasoconstriction by lowering PaCO2

Hyperventilation lowers PaCO2, which causes cerebral vasoconstriction, reducing cerebral blood volume and transiently decreasing ICP.

Which imaging modality is the gold standard for initial evaluation of acute traumatic brain injury in the emergency department?

Answer: Non-contrast CT scan of the head

Non-contrast CT is the gold standard because it is fast, widely available, and reliably identifies hemorrhage, skull fractures, and mass effect.