HEAD TRAUMA

Question 1

Red Flags

Answer 1

GCS 13-15

witnessed LOC

definite amnesia

witnessed disorientation

GCS <15 at 2 hours post injury

Suspected open or depressed skull fracture

Any sign of basilar skull fracture(hemotyopanum, raccoon eyes, battle’s sign, CSF, oto-/rhinorrhea

*Anticoagulation

> /2 episodes of vomiting

Age >/ 65 yrs

Question 2

Management: Epidural & Subdural Hematoma

Answer 2

Consult neurosurgery for management

Reduce ICP: raise head of bead to 30°; IV Mannitol 1g/kg over 20 mins or
HTS 1.25-5mL/kg over 5 mins
hyperventilation
diuretics

Reverse anticoagulation (i.e. give prothrombin complex concentrate if on
Warfarin or Xa inhibitors; Praxbind for Dabigatran)