ABSTRACT
Pre-hospital management of traumatic brain injury (TBI) clearly influences the morbidity
and mortality outcomes in patients with TBI. Recent clinical and laboratory evidence
suggests that secondary brain injuries can be lessened with appropriate and expeditious
interventions performed in the pre-hospital arena. Hypotension, even a single episode
of systolic blood pressure < 90 mm Hg, and hypoxia have powerful negative effects
on outcome. The recognition and treatment of these conditions can be fairly simple
and uncomplicated, including fluid boluses with isotonic or hypertonic saline and
field intubation. Other pre-hospital interventions, such as hyperventilation and steroid
doses, have proved to be harmful or ineffective in the overall management of TBI.
However, conflicting opinion and unclear evidence only demonstrate the need for better
class I evidence in pre-hospital management of head trauma.
KEYWORDS
Hypotension - hypoxia - pre-hospital management - traumatic brain injury