Abstract
M15 previously healthy was hit by a car travelling at 30 mph while crossing the road. He had a cardiac arrest at the scene, with bystander CPR for 4 min. He required chest compressions by LAS with return of systemic circulation after 9 min, not requiring adrenaline. He I+V at scene and had bilateral thoracostomies performed by HEMS who transferred him to A+E. He received hypertonic saline en-route in view of concerns regarding raised intracranial pressures. Pupils had reacted for a short while after but then became persistently fixed and dilated. On arrival to ED, pupils were fixed, dilated 7 cm and non-reactive. Further boluses of hypertonic saline were given to no effect.
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Abbreviations
- A+E:
-
Accident and emergency department
- ASDH:
-
Acute subdural haematoma
- DAI:
-
Diffuse axonal injury
- EDH:
-
Extradural haematoma
- HEMS:
-
Helicopter emergency medical service
- I+V:
-
Intubated and ventilated
- LAS:
-
London ambulance service
- TBI:
-
Traumatic brain injury
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Tolias, C.M., Giamouriadis, A., Hogg, F.R.A., Ghimire, P. (2019). Severe Traumatic Brain Injury: Brainstem Death Tests. In: Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98234-2_7
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DOI: https://doi.org/10.1007/978-3-319-98234-2_7
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