Volume 12, Issue 10: Traumatic brain injury – careful of the Cushing’s

Traumatic brain injury – careful of the Cushing’s

Blurb

Another long, busy day for you and the student paramedic on your shift, you’ve barely finished lunch when you are called to a “C2 emergency response” for an unconscious male, 68 years of age, who has fallen in the back garden. The patient has a head injury, is disoriented and losing a lot of blood, you decide to extricate immediately but should you have taken more time to consider what to do next?

CPD benefit

Traumatic brain injury (TBI) is a rapid insult to the brain from an external mechanical force and contributes towards 30% of all injury related deaths annually worldwide. As first responders the critical interventions care and support provided by ambulance clinicians can have a long-lasting impact on the patient’s trajectory of care outcome and future recovery. This article has information on the anatomy and pathophysiology of TBI and guidance on assessing the severity of the injury including recognising Cushing’s response, a pre-terminal sign of impending cerebral herniation that may result in brain death. It shows you how to put in place effective pre-hospital management of patients with TBI to ensure they receive prompt early imaging and interventions by trauma specialists.