Pediatric TBI: Early Evaluation and Stabilization-Handout - Pediatric TBI: Early Evaluation and Stabilization

Handout - Pediatric TBI: Early Evaluation and Stabilization

Pdf Summary

The document discusses the early evaluation and stabilization of pediatric traumatic brain injury (TBI). It emphasizes the importance of reliable airway management, intubation if necessary, and avoiding hypoxemia and hypotension in the pre-hospital setting. Upon arrival at the hospital, the medical history of the patient should be obtained, including information on the incident, tests performed, and any medications given. Transfer of pediatric trauma patients should be done promptly and efficiently, with criteria for level 1 neuro activation outlined. In the trauma bay, initial goals include evaluating for other sources of injury and obtaining a head CT scan within 20 minutes. The document also highlights the importance of monitoring intracranial pressure (ICP) and maintaining adequate cerebral perfusion pressure (CPP). It recommends using ICP monitoring for severe TBI cases, as well as continuous CSF drainage for high ICPs. The use of hypertonic saline, pain management, sedation, and ventilation strategies are also discussed. Additional topics covered include coagulopathy following TBI, seizure prevention, and treatments such as barbiturates and decompressive surgery for refractory intracranial hypertension. The document concludes by mentioning the options of hypothermia, burst suppression on EEG, and moderate hyperventilation as last resort measures.

Keywords

pediatric traumatic brain injury

airway management

intubation

hypoxemia

hypotension

head CT scan

intracranial pressure

cerebral perfusion pressure

CSF drainage

pain management