MANAGEMENT OF MILD TBI (GCS 13-15) Flashcards
Initial Management
Determine mechanism, time of injury, initial GCS, confusion, amnesia, amnestic interval, seizure, headache severity etc.
Anticoagulant Use
AMPLE hx
Secondary survey includes focused neurological exam
Diagnostics
CT Scanning as determine by head CT rules
Blood/Urine EtOH and toxicology screens
Secondary Management
Serial neuro examinations until GCS is 15 and patient has no preservation or memory deficits
Rule out indication for CT
Disposition
Home if patient does NOT meet the criteria for admission
Discharge with head injury warning sheet and follow up arranged
Indications for Admission
Focal neurological deficit
Vomiting (> two episodes)
Age > 65
GCS does not return to I5 within 2 hours
No CT available
CT abnormal, skull fracture, CSF leak,
Significant intoxication (admit or observe)
Management if Admission
Perform serial neurological examinations
Perform follow up CT if first is abnormal or GCS remains less than 15
Repeat CT (or transfer) if neurological status deteriorates and neurosurgical evaluation