GCS
What are the 3 GCS Categories
Eye opening response
Verbal Response
Motor Response
What is a traumatic brain injury
An alteration in brain function, or other evidence of brain pathology, caused by an external force
Abnormal CT (hematoma, contusion, edema, herniation, compressed basal cisterns); age >40, Unilateral or bilateral postering, SBP <90
What are the two different forms of whole blood
Stored whole blood and fresh whole blood
List 3 criteria for requiring a blood transfusion
HR >100, SBP< 100, rapid shallow breaths, weak/thready pulse, pale/cyanotic skin color, above the knee amputations, multiple amputations, AMS, continued bleeding from non compressible wounds
What GCS score range signifies a mild TBI
13-15
List 3 indications for CT and Neuro eval in TBI pts
•Continued GCS <14; Confused or have continued cognitive deficits; Penetrating brain injury; Open skull fracture; Moderate or severe brain injury; Head trauma and unexplained neurologic deficits
What is goal ICP
<22 mmHg
List 2 risk factors when using FWB
Increased risk of transmitted infections; ABO mismatch; unsanitary field conditions
TXA has greatest benefit within 1-_hours of injury
3
3-8
What is the antiepileptic of choice for TBI patients
Keppra
Keppra 1500mg IV loading dose
What does CPP stand for?
Cerebral Perfusion Pressure
What blood type is considered "universal WB"
LTOWB
Citrate preservative in blood products can chelate_
Calcium
What motor score does a pt with decorticate postering receive
3
What is the degree of head of bed elevation for TBI patients
30-45 degrees
How do you calculate CPP
CPP=MAP-ICP
What antibody titers are measured in O type blood
Anti-A and Anti-B
List 3 different acute transfusion reactions
Transfusion Associated Circulatory Overload
Transfusion-related acute lung injury
Anaphylaxis
Acute hemolytic reactions
What are the criteria for brain death?
GCS score of 3 and at least 3 among pupillary light, corneal, pharyngeal, carinal, oculovestibular, and trigeminal reflexes were absent
What is the recommended antibiotic and dosing for grossly contaminated penetrating brain injuries
Metronidazole 500mg Q8-12H
What are the 3 locations for ICP Monitoring
Subarachnoid, Intraparenchymal, and intraventricular
What are the components for the ABC Score
Penetrating mechanism, SBP<90, HR 120, Positive Fast
TXA is an anti-fibrinolytic that inhibits both _ and _ activation?
Plasminogen and plasmin