Abstract
Traumatic Brain Injury (TBI) was chosen as an Emergency Neurological Life Support topic due to its frequency, the impact of early intervention on outcomes for patients with TBI, and the need for an organized approach to the care of such patients within the emergency setting. This protocol was designed to enumerate the practice steps that should be considered within the first critical hour of neurological injury.
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Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 2010.
Stiell IG, Nesbitt LP, Pickett W, et al. The OPALS major trauma study: impact of advanced life-support on survival and morbidity. CMAJ. 2008;178:1141–52.
Gausche M, Lewis RJ, Stratton SJ, et al. Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: a controlled clinical trial. JAMA. 2000;283:783–90.
Davis DP, Peay J, Sise MJ, et al. The impact of prehospital endotracheal intubation on outcome in moderate to severe traumatic brain injury. J Trauma. 2005;58:933–9.
Jensen JL, Cheung KW, Tallon JM, Travers AH. Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review. CJEM. 2010;12:135–40.
Bickell WH, Wall MJ Jr, Pepe PE, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994;331:1105–9.
Brain Trauma F, American Association of Neurological S, Congress of Neurological S, et al. Guidelines for the management of severe traumatic brain injury. VI. Indications for intracranial pressure monitoring. J Neurotrauma. 2007;24 Suppl 1:S37-44.
Cooper DJ, Myles PS, McDermott FT, et al. Prehospital hypertonic saline resuscitation of patients with hypotension and severe traumatic brain injury: a randomized controlled trial. JAMA. 2004;291:1350–7.
Katsnelson M, Mackenzie L, Frangos S, et al. Are initial radiographic and clinical scales associated with subsequent intracranial pressure and brain oxygen levels after severe traumatic brain injury? Neurosurgery. 2012;70:1095–105.
Heuer G, Hurst R, le Roux PD. Traumatic Carotid Artery Injury. In: Winn HR, ed. Youmans Textbook of Neurological Surgery. 6th ed. New York: Elsevier; 2011.
Samant UB 4th, Mack CD, Koepsell T, Rivara FP, Vavilala MS. Time of hypotension and discharge outcome in children with severe traumatic brain injury. J Neurotrauma. 2008;25(5):495–502.
Vavilala MS, Bowen A, Lam AM, et al. Blood pressure and outcome after severe pediatric traumatic brain injury. J Trauma. 2003;55(6):1039–44.
Oddo M, Le Roux PD. What is the etiology, pathogenesis and pathophysiology of elevated intracranial pressure? In: Neligan P, Deutschman CS, editors. The Evidenced Based Practice of Critical Care. Philadelphia: Elsevier Science; 2009.
Miller C, Armonda R. Participants in the international multi-disciplinary consensus conference on multimodality monitoring. Monitoring of cerebral blood flow and ischemia in the critically ill. Neurocrit Care. 2014;21(Supple2):S121–8.
Marmarou A. A review of progress in understanding the pathophysiology and treatment of brain edema. Neurosurg Focus. 2007;22:E1.
Stein SC, Smith DH. Coagulopathy in traumatic brain injury. Neurocrit Care. 2004;1:479–88.
Talving P, Benfield R, Hadjizacharia P, Inaba K, Chan LS, Demetriades D. Coagulopathy in severe traumatic brain injury: a prospective study. J Trauma. 2009;66:55–61.
Cap AP, Spinella PC. Severity of head injury is associated with increased risk of coagulopathy in combat casualties. J Trauma. 2011;71:S78–81.
O’Neil BR, Handler MH, Tong S, Chapman KE. Incidence of seizures on continuous EEG monitoring following traumatic brain injury in children. J Neurosurg Pediatr. 2015;8:1–10.
Temkin NR, Dikmen SS, Wilensky AJ, Keihm J, Chabal S, Winn HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med. 1990;323:497–502.
Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury XIII. Antiseizure prophylaxis. J Neurotrauma. 2007;24(Suppl 1):S83–6.
Narayan RK, Kishore PR, Becker DP, et al. Intracranial pressure: to monitor or not to monitor? A review of our experience with severe head injury. J Neurosurg. 1982;56:650–9.
Kochanek PM, Carney N, Adelson PD, Suppl1, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children and adolescents—second edition. Pediatr Crit Care Med. 2012;Suppl1:S1–82.
Andrews PJ, Citerio G, Longhi L, et al. NICEM consensus on neurological monitoring in acute neurological disease. Intensive Care Med. 2008;34:1362–70.
Maas AI, Dearden M, Teasdale GM, et al. Acta Neurochir (Wien). 1997;139:286–94.
Chesnut R, Videtta W, Vespa P, LeRouX P. International multimodality monitoring conference. intracranial pressure monitoring: fundamental considerations and rationale for monitoring. Neurocrit Care. 2014;21:564–84.
Smith M. Monitoring intracranial pressure in traumatic brain injury. Anesth Analg. 2008;106:240–8.
Ehtisham A, Taylor S, Bayless L, Klein MW, Janzen JM. Placement of external ventricular drains and intracranial pressure monitors by neurointensivists. Neurocrit Care. 2009;10:241–7.
Bauer DF, McGwin G Jr, Melton SM, George RL, Markert JM. The relationship between INR and development of hemorrhage with placement of ventriculostomy. J Trauma. 2011;70:1112–7.
Timofeev I, Dahyot-Fizelier C, Keong N, et al. Ventriculostomy for control of raised ICP in acute traumatic brain injury. Acta Neurochir Suppl. 2008;102:99–104.
Birch AA, Eynon CA, Schley D. Erroneous intracranial pressure measurements from simultaneous pressure monitoring and ventricular drainage catheters. Neurocrit Care. 2006;5:51–4.
Martinez-Manas RM, Santamarta D, de Campos JM, Ferrer E. Camino intracranial pressure monitor: prospective study of accuracy and complications. J Neurol Neurosurg Psychiatry. 2000;69:82–6.
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of depressed cranial fractures. Neurosurgery. 2006;58:S56–60.
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of posterior fossa mass lesions. Neurosurgery. 2006;58:S47–55.
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of traumatic parenchymal lesions. Neurosurgery. 2006;58:S25–46.
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of acute subdural hematomas. Neurosurgery. 2006;58:S16–24.
Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of acute epidural hematomas. Neurosurgery. 2006;58:S7–15.
Cooper DJ, Rosenfeld JV, Murray L, et al. Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med. 2011;364:1493–502.
Sahuquillo J, Arikan F. Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database Syst Rev. 2006:CD003983.
Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80:2250–7.
West TA, Marion DW. Concurrent recommendations for the diagnosis and treatment of concussion in sport: a comparison of three new guidelines. J of Neurotrauma. 2014;31:159–68.
Centers for Disease Control and Prevention (2013). Injury prevention and control. Available at: http://www.cdc.gov/injury/about/focus-tbi.thml. Accessed September 30, 2013.
Guerriero RM, Proctor MR, Mannix R, Meehan WP III. Epidemiology, trends, assessment and management of sports-related concussion in United States high schools. Curr Opin Pediatr. 2012;24:696–701.
Harmon K, Drezner J, Gammons M, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Clin J Sport Med. 2013;23:1–18.
Marsh AM, Fraser D, Marsh JP. Management of concussion in the pediatric patient. J Pediatr Health Care. 2013;27:499–504.
Langlois JA, Rutland-Brown W, and Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury and Prevention Control, Atlanta 2006 (Statistical data).
Faul M, Xu L, Wald MM, and Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010 (Statistical data).
Morray JP, Tyler DC, Jones TK, et al. Coma scale for use in brain injured children. Crit Care Med. 1984;12:1018–20.
Kapapa T, Konig K, Pfister U, et al. Head trauma in children, part 1: admission, diagnosis, and findings. J Child Neurol. 2010;25:146–56.
Simpson D, Reilly P. Pediatric coma scale. Lancet. 1982;2:450.
James HE. Neurologic evaluation and support in the child with an acute brain insult. Pediatr Ann. 1986;15:16–22.
Badjatia N, Carney N, Crocco TJ, et al. Guidelines for prehospital management of tramatic brain injury, 2nd edition. Prehosp Emerg Care. 2008;12(Suppl 1):S1–52.
Pang D. Spinal cord injury without radiologic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325–42.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2:81.
Holmes JF, Palchak MJ, MacFarlane T, Kuppermann N. Performance of the pediatric Glasgow coma scale in children with blunt head trauma. Acad Emerg Med. 2005;12:814.
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Garvin, R., Venkatasubramanian, C., Lumba-Brown, A. et al. Emergency Neurological Life Support: Traumatic Brain Injury. Neurocrit Care 23 (Suppl 2), 143–154 (2015). https://doi.org/10.1007/s12028-015-0176-z
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DOI: https://doi.org/10.1007/s12028-015-0176-z