Neuroprotective Ventilation in Traumatic Brain Injury

Author: Alexander Hieatt / Editor: Adrian Boyle / Reviewer: Jennifer Lockwood, Alexander Hieatt / Code: R1, R3 / Published: 29/12/2022

A 21-year-old male is involved in a high speed RTC. He has a GCS of 6/15 at the scene and has an isolated head injury.

He is intubated at the roadside by the pre-hospital doctor and brought into the Emergency Department (ED). Ketamine was use as the induction agent, suxamethonium then pancuronium for paralysis.

During transit he is has been kept anaesthetised with boluses of morphine 1-2 mg and midazolam 1-2 mg as required.

He has maintained a systolic BP of >110 mmHg throughout and remained in sinus rhythm. He was saturating at 92% on air at the scene prior to oxygen administration and has maintained saturations of 97-100% since.

He has been ventilated with CMV with the pre hospital team. You now have to transfer him to the ventilator in your resuscitation room.

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