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n CME : Your SA Journal of CPD - Management of head injury for anaesthetis ts : main article
The injured brain is susceptible to insults that, under physiological conditions, would not cause damage.
Preventing and treating secondary insults seems to offer the most hope for optimising outcome following TBI.
Prevention of hypoxia, hypotension, seizures and the rapid evacuation of intracranial haematomas offer the best advantages.
Hypothermia, routine hyperventilation and steroids offer no benefit.
Life-saving surgery may take priority over the TBI.
Non-life-saving surgery should be delayed until the TBI has stabilised, ideally 48 - 72 hours or more after injury.
If used carefully most anaesthetic techniques and drugs are suitable, with a few exceptions.
Attention to the general principles of care, especially avoiding hypotension, is key to maximising the neurological outcome.
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